Cover Image
QR Code

Anesthetic Management of a Laboring Patient With a Closed-Loop Stimulation Pacemaker: A Case Report.

A new generation of cardiac implantable devices, known as Closed Loop Stimulation pacemakers, are now utilized to reduce episodes of bradycardia, syncope, and tachycardia in pregnant women. The device functions differently than conventional pacemakers by responding to changes in the patient's cardia...

Full description

Published in:AANA Journal Vol. 87; no. 6; pp. 483 - 489
Main Author: Ray, Sheila B.
Format: case study tables/charts Journal Article
Published: American Association of Nurse Anesthetists Dec2019
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=140207896&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 140207896
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        00946354
        GLR
      jtl: AANA Journal
      issn: 00946354
      maglogo: N
    pubinfo:
      dt: Dec2019
      vid: 87
      iid: 6
      pid: 11824
      pub: American Association of Nurse Anesthetists
      place: Park Ridge, Illinois
    artinfo:
      ui:
        140207896
        140207896
        140207896
        140207896
      ppf: 483
      ppct: 6
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Anesthetic Management of a Laboring Patient With a Closed-Loop Stimulation Pacemaker: A Case Report.
      aug:
        au: Ray, Sheila B.
        affil: Founded the MSMP Anesthesia Services, L.L.C. Columbia, Missouri
      sug:
        subj:
          Cardiac Patients In Pregnancy
          Pacemaker, Artificial In Pregnancy
          Labor Nursing
          Anesthetics In Pregnancy
          Women's Health
          Female
          Adult
          Pregnancy
          Labor, Induced
          Pain Management Methods
          Certified Registered Nurse Anesthetists
          Analgesia
          Adult: 19-44 years
          Female
      ab: A new generation of cardiac implantable devices, known as Closed Loop Stimulation pacemakers, are now utilized to reduce episodes of bradycardia, syncope, and tachycardia in pregnant women. The device functions differently than conventional pacemakers by responding to changes in the patient's cardiac output and heart rate based on physiologic demands and acute mental stress. Increased metabolic demands, including physiologic stress often accompany pregnancy, labor, and delivery. The Certified Registered Nurse Anesthetist providing analgesia and anesthesia for the laboring patient with CLS pacemaker may encounter rapid changes in heart rates, initiation of pacing modes, and hypotension resulting from reduced cardiac outputs. The ability to differentiate and diagnose the causes of hemodynamic changes and provide appropriate interventions is essential to optimize maternal and fetal outcomes. This case report details the anesthetic management of a laboring twenty-five-year-old primigravida with an implantable CLS pacemaker secondary to a history of third degree heart block, cardiac ablation after supraventricular tachycardia, and seizures. The parturient experienced intermittent pacing after neuraxial analgesia. Anticipation of the CLS pacemaker's response to the parturient's physiological and emotional response during the labor process will be discussed including recommendations to optimize maternal and fetal outcomes.
      pubtype: Academic Journal
      doctype:
        case study
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N