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Feature Article

Managing patients after implantation of a cardiac rhythm management device

HITESH C. PATEL, HARIHARAN RAJU, Alex Voskoboinik, JUSTIN A. MARIANI

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Abstract

Patients with cardiac rhythm management devices such as pacemakers and defibrillators are cared for jointly by GPs and cardiologists. GPs can manage issues such as wound care, bleeding and pain, and provide guidance regarding work, travel and household appliance use.

Key Points

  • Implanted cardiac rhythm management (CRM) devices are commonly used in Australia.
  • The main types of implanted devices are pacemakers, defibrillators, biventricular pacemakers/defibrillators and implantable loop recorders.
  • Care of patients with CRM devices should be jointly shared between the GP and cardiologist.
  • Early complications are best referred back to the interventional cardiologist; they include wound-related issues (active bleeding, infection, large haematoma), unusual postprocedural pain (pericardial or pleuritic pain) and noncardiac muscle twitching.
  • There are many misconceptions in patients with implanted CRM devices regarding legal and safe driving, the use of household devices such as mobile phones and microwave ovens, foreign travel and working safely in environments where there are sources of electromagnetic interference.

    Picture credit: © Aberration Films Ltd/SPL/Diomedia.com

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