安置植入型心脏转复除颤器患者的麻醉？？？

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患者，男，70岁，因右肺包块，拟在全麻下行肺叶切除手术，5年前因病态窦房结综合症安装永久心脏起搏器，6个月前又因室性心动过速而将起搏器升级为具备双腔起搏功能的植入型心脏转复除颤器。这类病人术中应注意什么，外科医生要使用电刀，心脏转复除颤器的除颤功能要关闭嘛？术中出现室颤该怎么办，起搏器是否该程控为非同步化起搏模式？这类手术需要起搏器厂家工程师跟台嘛？谢谢大家给些意见？本人QQ号4720230.

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The patient with a cardiac pacemaker or implanted defibrillator and management during anaesthesia
Marc A. Rozner

Preoperative key points      
1 Have the pacemaker or defibrillator interrogated by a competent authority shortly before the anesthetic
2 Obtain a copy of this interrogation. Ensure that the device will pace the heart with appropriate safety margins
3 Consider replacing any device near its elective replacement period in a patient scheduled to undergo either a major surgery or surgery within 25cm of the generator
4 Determine the patient’s underlying rhythm/rate to determine the need for backup pacing support
5 Identify the magnet rate and rhythm, if a magnet mode is present and magnet use is planned
6 Program minute ventilation rate responsiveness off, if present
7 Program all rate enhancements off
8 Consider increasing the pacing rate to optimize oxygen delivery to tissues for major cases
9 Disable antitachycardia therapy if a defibrillator

Intraoperative key points
1 Monitor cardiac rhythm/peripheral pulse with pulse oximeter or arterial waveform
2 Disable the ‘artifact filter’ on the EKG monitor
3 Avoid use of monopolar electrosurgery
4 Use bipolar ESU if possible; if not possible, then pure cut (monopolar ESU) is better than ‘blend’ or ‘coag’
5 Place the ESU current return pad in such a way to prevent electricity from crossing the generator-heart circuit, even if the pad must be placed on the distal forearm and the wire overed with sterile drape
6 If the ESU causes ventricular oversensing, pacer quiescence, or tachycardia, limit the period(s) of asystole or reprogram the device

Postoperative key points
Have the device interrogated by a competent authority postop. Some rate enhancements can be re-initiated and optimum heart rate and pacing parameters should be determined. The ICD patient must be monitored until the antitachycardia therapy is restored.

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那位大侠翻译一下嘛。。。