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Cardiopulmonary effects of internal cardioverter/defibrillator implantation
Author(s) -
Hachenbero T.,
Hammel D.,
Möllhoff T.,
Brüssel T.,
Block M.,
Borggrefe M.,
Haberecht H.,
Scheld H. H.,
Wendt M.
Publication year - 1991
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1991.tb03361.x
Subject(s) - medicine , cardiology , ventricular fibrillation , inotrope , vascular resistance , ventricular tachycardia , hemodynamics , implantable cardioverter defibrillator , perfusion , anesthesia , heart failure , tachycardia , cardiac index , cardiac output
Cardiopulmonary effects of electrophysiological testing of internal cardioverter/defibrillator (ICD) devices were studied in ten patients undergoing general anaesthesia. In the control‐phase, haemodynamic performance and oxygenation were slightly impaired. After completion of the electrophysiological procedures (ICD‐phase), cardiopulmonary function had deteriorated significantly. Cardiac index declined by 16%, whereas left ventricular filling pressure and pulmonary vascular resistance increased ( P ≤0.01). Oxygenation, but not CO 2 ‐elimination deteriorated ( P ≤0.01) and venous admixture increased by 72% ( P ≤0.01). Alveolo‐arterial Po 2 ‐difference (P A‐a O 2 ) increased by 43% ( P ≤0.01), indicating ventilation‐perfusion (V A /Q) mismatching. Repeated inductions of ventricular tachycardia and/or fibrillation subject the myocardium to transient global ischaemia, leading to acute congestive heart failure, and positive inotropic intervention was necessary in 40% of the patients. Partial pulmonary insufficiency resulted possibly from interstitial oedema and V A /Q‐inhomogeneities. ICD implantation has detrimental effects on haemodynamics and gas exchange in patients with impaired left ventricular function.