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Recent statistics point to an increasing number of patients in North America with cardiovascular implantable electronic devices (CIEDs), which include implantable cardiac pacemakers, implanted cardioverter-defibrillators (ICDs), cardiac resynchronization devices, and implantable cardiac monitors. In 2012, it was estimated that at least 3 million patients have these devices implanted and more than 250,000 new devices are implanted each year. 1 Of major concern to the dentist practitioner is the possibility of electromagnetic

scientific literature and analysis of expert opinion, clinical feasibility data, open forum commentary, and consensus surveys. This updated advisory focuses on the perioperative management of the patient who has a pre-existing cardiac implantable electronic device (CIED) for the treatment of a bradyarrhythmia, tachyarrhythmia, or heart failure. It applies to all patients with a CIED receiving general or regional anesthesia, sedation, or monitored anesthesia care. Both inpatient and outpatient procedures are addressed by this update. A focused preoperative

Cardiac arrest, 34 Cardiopulmonary resuscitation, 62 Cardiorenal syndrome, 34 Cauterization, 95 Charcot-Marie-Tooth disease, 80 CIED, 95 Congenital heart disease, 201 Congestive heart failure, 34 Conscious sedation, 25 Coronary artery steal, 42 Cough reflex, 185 Deep sedation, 185 Defibrillation, 95 Dental anesthesia, 84, 116, 139, 192 Dental education, 62 Dental emergency, 34 Dental injection technique, 192 Dental radiographs, 181