Environmental and drug effects on patients with pacemakers and implantable cardioverter/defibrillators: A practice guide to patient treatment

The potential for interaction between pacemakers and implantable cardioverter/defibrillators (ICDs) and the medical and nonmedical environment, and between these devices and certain cardioactive drugs, has been recognized for years. Whereas a number of experimental and clinical studies have been performed to define some of these interactions, in many instances data are sparse and anecdotal clinical experiences form the basis for decision making and recommendations. Nevertheless, given the proliferation of rhythm-management devices in use in the population today, practitioners may find a guide to management of these patients helpful. This management guideline is therefore offered not as an extensive, literature-based review, but as a framework on which to understand specific types of problems that may be encountered in the daily lives of patients who have such implanted devices.