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Special Article |

Environmental and Drug Effects on Patients With Pacemakers and Implantable Cardioverter/Defibrillators:  A Practical Guide to Patient Treatment

Nora Goldschlager, MD; Andrew Epstein, MD; Paul Friedman, MD; Eli Gang, MD; Ryszard Krol, MD, PhD; Brian Olshansky, MD ; for the North American Society of Pacing and Electrophysiology (NASPE) Practice Guideline Committee
Arch Intern Med. 2001;161(5):649-655. doi:10.1001/archinte.161.5.649.
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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.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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