Valvular Heart Disease and Pacemaker for Cholecystectomy

You are asked to review an 82-year-old man in preadmission clinic. He has been referred for assessment prior to a laparoscopic cholecystectomy in 2 weeks' time. He has had 2 recent admissions with cholecystitis which have required intravenous antibiotics. Past Medical History Valvular heart disease Sick sinus syndrome with a pacemaker Hypertension Stage III chronic kidney disease Medications Apixaban 2.5mg twice daily Metoprolol 50mg twice daily Telmisartan 40mg nocte Ezetimibe/atorvastatin 10mg/80mg mane Vital Signs Height 1.76 m Weight 75 kg BMI 24 kg/m2 BP 176/92 mmHg HR 62 bpm SpO2 96% on room air Temp 36.4 oC