A symposium, "Perioperative Management of Pacemaker Patients", was held in May 1990 at the Karl-Franzens-Universitat, Landeskrankenhaus Graz, Austria. The purpose of the symposium, organized by the Departments of Anesthesiology and Surgery, was to discuss the current status of permanent pacemaker technology, emerging developments in this field, legal issues, indications and methods for tempor ary perioperative pacing, and the potential for pacemaker malfunction and adverse patient-pacemaker interactions in perioperative and other medical settings. It was hoped that participants would come to some consensus concerning recommendations for satisfactory perioperative management of pacemaker patients. This symposium was probably the fIrst occasion ever that brought together representatives of the pacemaker industry, implanting physicians, and physicians responsible for the management of pacemaker patients in perioperative and other hospital settings to discuss these important matters. Certainly, it was recognized by all who attended that there existed at the time little in the way of substantial knowledge of how to best manage pacemaker patients or patients with possible indications for temporary pacing in "unique" hospital settings especially with exposure to electroma gnetic and other potential interference, but in the absence of professional persons with direct knowledge of pacemakers and related devices. Much new information was presented and useful ideas exchanged, so that three symposium participants were of the opinion that papers presented at this meeting should be published as a collective work.

In this book are discussed topics of particular importance to critical care cardiovascular diagnosis and management in the perioperative period. Chapter topics are the causes for heart failure; the pathophysiology of heart failure; coronary heart disease and ischemic preconditioning; hypertensive urgencies and emergencies; diagnosis of heart failure; preoperative cardiac risk assessment; hemodynamic monitoring in patients with heart failure; electrocardiography of heart failure - features and arrhythmias; pharmacologic management for patients with heart failure; devices for management of heart failure; pacemaker and internal cardioverter-defibrillator therapies; management of cardiopulmonary arrest; circulatory shock - anaphylactic, cardiogenic, haemorrhagic, septic; prevention and management of cardiac dysfunction during and after cardiac surgery; vasodilator therapy - systemic and pulmonary; and, thromboembolism and anticoagulation. This work represents an important update for anaesthesiologists, cardiologists, cardiac surgeons, emergency care physicians and intensivists caring for patients with acute, life-threatening cardiovascular afflictions.