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1、围手术期间心脏植入装置的管理专家共识解读南昌大学第二附属医院鲍慧慧TheHeartRhythmSocietyExpertConsensus（2011AHA/ACC/ASA/STS）CommitteeStaff8AHA/ACC/4ASA/1STSNashville,TN；Seattle,WA；Houston；TX,Rochester,MNBaltimore；Cleveland,OHGreenville,NC；Hanover,NHCharleston,SC；WestDesMoines,IACleveland,OH；Jacksonville,FLCharlo
2、ttesville,VA；Nashville,TNEngineersfrom：概要介绍医疗操作期间可能出现的问题ProblemsthatcanoccurduringmedicalproceduresPreoperativeevaluationofapatientwitha心脏植入性电子装置（CIED）患者术前评估心脏植入性电子装置（CIED）患者手术中管理与思考Intraoperativemanagementandconsiderations心脏植入性电子装置术中的评估IntraoperativeevaluationofCIEDsAbbreviatio
3、nsCIED：CardiovascularimplantableelectronicdevicesEMI：ElectromagneticinterferenceECT：ElectroconvulsivetherapyCIEDteam：Physician,nurse,andtechniciansPerioperativeteam：Anesthesiologist,surgeon，physician,nurseMorethan3,000,000deviceswereimplantedintheglobe全球约有三百万以上患者心脏植入装置700,000dev
4、iceswasimplantedin20092009年有700,000患者心脏植入装置Increasingattherateof15%everyyear每年以15%速度递增IntroductionEnsurepatientswithdevicessafeinperioperativeperiodNeedforaconsistentstatement1、RapidchangesinCIEDtechnology2、ExpandinguseofEMI3、ConfusingrecommendationsIntroductionProblemsthatcanoc
5、curduringmedicalproceduresEMIElectrosurgicalenergyEMIandCIEDsElectrosurgicalenergyIdentificationofproblemsspecifictopatientswithCIEDduringmedicalproceduresOversensingRateresponsivealgorithmsResetPulsegeneratordamageLead-tissueinterfacedamageEMIandCIEDsTransienteffectionsuchas：Pa
6、cinginhibitionInappropriatetrackingofelectricalnoiseDamageatthelead-tissueinterfacePulsegeneratordamageElectricalresetmodeRateresponsivealgorithmsExtentofabnormalbehaviordependson：StrengthDurationParticulartypeofinterferenceClinicalimpactdependson：Patient’sintrinsicrateandrhythm
7、PacingmodeFunctioningofprotectivecircuitryengineeredtofilteroutextraneouselectricalcurrentsEMIandCIEDsElectrosurgicalenergyBipolarelectrosurgery：(e.g.electricalforceps）UsedfarlesscommonlyonlyforcoagulationandnotdissectionMonopolarelectrosurgeryUtilizedformostsurgicalproceduresEl
8、ectrode：“Penorstylus”totheoperativesiteReturnel
