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Published ahead of print on August 5, 2004, doi:10.1164/rccm.200402-211UP
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American Journal of Respiratory and Critical Care Medicine Vol 170. pp. 933-940, (2004)
© 2004 American Thoracic Society
doi: 10.1164/rccm.200402-211UP

Update in Nonpulmonary Critical Care

Permanent Pacemakers and Implantable Defibrillators

Considerations for Intensivists

Craig A. McPherson and Constantine Manthous

Department of Internal Medicine, Sections of Cardiology and Pulmonary/Critical Care, Bridgeport Hospital and Yale University School of Medicine, Bridgeport, Connecticut

Correspondence and requests for reprints should be addressed to Constantine A. Manthous, M.D., Bridgeport Hospital, 267 Grant Street, Bridgeport, CT 06610. E-mail: pcmant{at}bpthosp.org

ABSTRACT

Pacemakers and cardioverter-defibrillators are implanted in patients with cardiovascular disease for an ever-increasing array of indications. Intensivists provide care frequently for patients who have these devices, and thus, they must be familiar with common problems and nuances that may contribute to critical illness. Close collaboration of the critical care physician and cardiologist/electrophysiologist assures that pacemakers and defibrillators are tuned to optimize the hemodynamic milieu of critically ill patients. Many recent advances in the sophistication of implanted devices are reviewed herein.

Key Words: arrhythmia • critical care • implantable cardiac defibrillator • pacemaker




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