Clinical Review
Management of Elderly Patients with Hip Fractures and Cardiac Rhythm Devices
Am J Orthop. 2010 September;39(9):450-453
Author and Disclosure Information
Derek F. Papp, MD, Joseph E. Marine, MD, and Simon C. Mears, MD, PhD
Dr. Papp is Resident, Department of Orthopaedic Surgery, Johns Hopkins University and Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Dr. Marine is Associate Professor of Medicine, Division of Cardiology, Johns Hopkins University, and Director, Electrophysiology Program, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Dr. Mears is Assistant Professor, Department of Orthopaedic Surgery, Johns Hopkins University, and Division Chief, Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
The annual incidence of hip fractures in the United States is expected to double by the year 2050. An additional challenge is that comorbidities are common in elderly patients. As indications for implantation of cardiac rhythm devices continue to broaden, the number of elderly patients with a pacemaker or an implantable cardioverter-defibrillator seen in the orthopedic surgeon’s practice is likely to increase. We review the unique properties and functions of the most commonly implanted cardiac rhythm devices, provide an algorithm to assist the surgeon in gathering important patient information and developing perioperative approaches to treatment, and detail potential intraoperative complications and their prevention.