ICD-ON Registry: Periop Management of Cardiac Devices

Study Overview
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Brief Summary
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The purpose of this registry is to document incidence of electrical magnetic interference (EMI), change in programmed parameters or device related events in patients with Pacemakers (PM) and Implanted Cardioverter Defibrillators (ICDs) having surgery requiring electrocautery. A standardized perioperative device management protocol (ICD-ON Protocol) will be used.

Detailed Description
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Patients with PMs and ICDs have traditionally been considered at risk for electrical magnetic interference (EMI) from electrocautery. EMI can cause oversensing, pacing inhibition, or inappropriate ICD therapies. In July 2011, the Heart Rhythm Society /American Society of Anesthesiologists (HRS/ASA) published an Expert Consensus Statement on the perioperative management of PM and ICDs. The purpose of this registry is to collect data on patients with PMs and ICDs undergoing procedures requiring electrocautery using a standardized device management protocol (ICD-ON Protocol). Decisions about management of patients with these devices will be made based on surgical location, programmed magnet response and pacemaker dependence. This registry will document incidence of EMI, changes in programmed parameters or device related events associated with the procedures. Observational data will be collected on participants including: medical history, device parameters, surgical/cautery data, and postoperative device follow-up. For procedures not requiring reprogramming, postoperative PM and ICD interrogation will be either routine in office follow-up or remote monitoring, as per the subject's routine.

Official Title
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ICD-ON Registry: Perioperative Management of Pacemakers and Implanted Cardioverter Defibrillators

Conditions
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Oversensing Cardiac Pacemaker, ICD, Surgery

Participation Criteria
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Eligibility Criteria
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Have a implanted PM or ICD Be scheduled for a procedure with anticipated electrocautery Be able to speak, read and understand English Be willing to sign consent form Exclusion Criteria: Have an ICD from Boston Scientific under Product Advisory related to magnet performance Have an ICD or PM from Biotronik or Sorin Surgical procedures with two or more electrocautery operators.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of EMI. | Percentage of patients with EMI, defined as oversensing on atrial or ventricular electrograms during electrocautery. | up to 90 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of pacing inhibition in pacemaker dependent patients with procedures > 6 inches from device. | Percentage of patients with pacing inhibition recorded intraoperative or on postoperative electrograms during time of electrocautery. | up to 90 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pacemaker, ICD, Surgery, Electrocautery, Electromagnetic interference