心脏植入式电子设备的围手术期管理：最新的叙述性综述
Perioperative management of cardiac implantable electronic devices: a state of the art narrative review.
摘要(中文译文)
心脏植入式电子设备（CIEDs）为严重心动过缓或存在恶性心律失常风险的患者提供了挽救生命的治疗。随着这些设备的植入量和技术复杂程度持续增加，围手术期临床医生必须掌握其管理知识。尽管各学会已发布指导文件，但部分建议存在差异。此外，许多学会在过去几年内发布了更新或新的指导文件。本综述旨在总结最新的CIEDs类型及围手术期管理建议。通过检索PubMed，重点查找2020年1月至2025年9月期间主要国家和国际组织发布的指南、共识声明和实践建议。随后根据初始文献内容进行二次检索。仅纳入英文文献。共检索到五份指导文件。部分文件获得多个组织认可，其中值得注意的组织包括：（I）美国麻醉医师学会（ASA）；（II）欧洲心律协会（EHRA）/心律学会；（III）英国心律学会；（IV）美国心脏协会（AHA）/美国心脏病学会（ACC）；（V）AHA。熟悉这些设备及其围手术期管理方法对于在围手术期安全照护这些患者至关重要。尽管围手术期管理策略之间存在相似之处，但各学会的建议存在差异。此外，各文件的范围不同，部分更为详细，部分则缺乏细节。在缺乏统一方案的情况下，临床医生熟悉各组织的指导文件、考虑文件的优势与局限性，并应用与患者最相关且最具针对性的建议，将有所裨益。
Abstract
Cardiac implantable electronic devices (CIEDs) offer lifesaving treatment in patients with significant bradycardia or who at risk for malignant arrhythmias. As the implantation and sophistication of these devices continue to increase, it is imperative for perioperative clinicians to be knowledgeable in their management. While societies have produced documents for guidance, they differ in some recommendations. Furthermore, many societies have released updated or new guidance within the last several years. This review aims to summarize the latest types of CIEDs and perioperative management recommendations. A search in PubMed was performed with a focus on locating guidelines, consensus statements, and practice advisories from major national and international organizations from January 2020 to September 2025. Secondary searches were subsequently conducted based on the content of the initial papers. Only papers in the English language were considered. Five guidance documents were retrieved based on the search. Some had endorsement from numerous groups, but notable organizations included: (I) the American Society of Anesthesiologists (ASA); (II) European Heart Rhythm Association (EHRA)/Heart Rhythm Society; (III) British Heart Rhythm Society; (IV) American Heart Association (AHA)/American College of Cardiology (ACC); and (V) AHA. Familiarity with these devices and how to manage them perioperatively is necessary to safely care for these patients in the perioperative period. Although there are similarities between perioperative management strategies, differences exist between recommendations from various societies. Furthermore, the scope of each of these documents differs, with some being more detailed and others lacking details. In the absence of a universal protocol, clinicians could benefit from being familiar with guidance from each of these organizations, taking into consideration the strengths and limitations of the documents, and applying the recommendation that is most relevant and specific to their patient.
如何引用
AMA
Rohesh J Fernando, Ettore Crimi, Karuna Puttur Rajkumar, Bryan E Marchant, Chandrika R Garner, Steven C Eastlack, et al. Perioperative management of cardiac implantable electronic devices: a state of the art narrative review.. Journal of thoracic disease. 2026; doi:10.21037/jtd-2026-1-0434.
APA
Rohesh J Fernando, Ettore Crimi, Karuna Puttur Rajkumar, Bryan E Marchant, Chandrika R Garner, Steven C Eastlack, et al (2026). Perioperative management of cardiac implantable electronic devices: a state of the art narrative review.. Journal of thoracic disease. https://doi.org/10.21037/jtd-2026-1-0434
GB/T 7714
Rohesh J Fernando, Ettore Crimi, Karuna Puttur Rajkumar, Bryan E Marchant, Chandrika R Garner, Steven C Eastlack, et al. Perioperative management of cardiac implantable electronic devices: a state of the art narrative review.[J]. Journal of thoracic disease, 2026 doi:10.21037/jtd-2026-1-0434.
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