Nontransvenous Cardiovascular Implantable Electronic Device Technology-A Review for the Anesthesiologist

J Cardiothorac Vasc Anesth. 2021 Feb 11;S1053-0770(21)00113-0. doi: 10.1053/j.jvca.2021.02.018. Online ahead of print.


There has been a recent shift in bradycardia pacing and defibrillation therapy to leadless pacemakers and extrathoracic cardioverter-defibrillator technology due to complications associated with transvenous devices. These innovations have implications for anesthesia care, as these novel devices have design and functionality features different from transvenous devices. Current perioperative guidelines do not address management of leadless pacemakers and the subcutaneous implantable cardioverter-defibrillator, although implantation rates are increasing globally. This article addresses the features and capabilities of nontransvenous cardiac implantable electronic devices, such as the Micra and the subcutaneous implantable cardioverter-defibrillator, and provides guidance for perioperative management.

Keywords: EMPOWER leadless pacemaker; Micra; Non-transvenous cardiovascular implantable electronic devices; Subcutaneous implantable cardioverter-defibrillator; WiSE CRT system.

Publication types

  • Review