TITLE:
Do Patients with Asymptomatic Congenital Complete Heart Block Require a Pacemaker for Non-Cardiac Surgery?
AUTHORS:
Barry Swerdlow
KEYWORDS:
Congenital Complete Heart Block, Pacemaker, Non-Cardiac Surgery
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.8 No.4,
April
30,
2018
ABSTRACT: The appropriate preparation of the patient with asymptomatic congenital complete heart block (CCHB) and a narrow QRS complex for elective non-cardiac surgery is controversial. Prophylactic temporary pacemaker insertion is associated with well-defined risks, and less invasive techniques exist to treat transient, hemodynamically significant intraoperative brady-arrhythmias. The present case report details the performance of general anesthesia for arthroscopic knee surgery in an adult patient with this condition without a pacemaker. Documentation of preoperative chronotropic competence with isoproterenol may be of value in deciding whether to proceed without temporary pacing capability in this setting.