An uncommon intraoperative implantable cardiac device compli
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As the indications for cardiac implantable electronic devices (CIED) have increased, there has been an increasing number of patients with such devices undergoing various surgical procedures. Careful perioperative evaluation and understanding of such devices are very important as these patients are subject to potentially fatal complications intraoperatively if there is a malfunction to their CIED.

This article presents a case of a 65-year-old female with a history of hypertension, sleep apnea, and nonischemic cardiomyopathy who presented for a scheduled left radical mastectomy. The patient had an ejection fraction of 35% with support of a biventricular implantable cardioverter defi brillator (ICD). This was placed 10 years ago in the left pectoral region. The patient had a biopsy-confirmed 11 cm grade 3 infiltrating carcinoma, with computed tomography scan of the chest showed that the breast mass was encompassing and involving the generator of the ICD. Before her breast tumor resection, the patient underwent implantation of new ICD generator in the right pectoral region...

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