Management of elderly patients with hip fractures and cardiac rhythm devices

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.