For a patient with a DDD-R pacemaker undergoing surgery, which pacing option should be used during the procedure?

In the context of a patient with a DDD-R pacemaker undergoing surgery, the optimal pacing option is to discontinue the rate response (R function). A DDD-R pacemaker is designed to provide dual-chamber pacing and has the capability to adjust the pacing rate based on the patient's physiological needs using the rate response feature. However, during surgery, particularly if the patient is to undergo general anesthesia or if certain medications may affect heart rate or conduction, it is prudent to turn off the rate response function. This prevents potential complications such as inappropriate pacing due to fluctuating physiological signals that may not accurately represent the patient’s needs during surgical manipulation.

This ensures that the pacemaker functions in a conventional pacing mode without automatically adjusting the rate, which could lead to instability during the surgical process. Keeping the pacing stable and predictable is crucial in a surgical environment where monitoring can be complex and physiological responses may be obscured.

The other options involve reprogramming or using different pacing modalities that may not align with the safety and stability required during surgery. They can introduce unnecessary variables, which could complicate the management of the patient during the procedure.