Journal article
Solvent-facilitated lead disconnection for battery replacement in patients with pacemakers or implantable cardioverter defibrillators.
- Erne P Laboratory of Signal Transduction, Department of Biomedicine, University Hospital Basel, Hebelstrasse 20, Basel CH 4031, Switzerland paul.erne@erne-net.ch.
- Kobza R Department of Cardiology, Luzerner Kantonsspital, Luzern 16 6000, Switzerland.
- Lehner M Biotronik Schweiz AG, Neuhofstrasse 4, Baar 6341, Switzerland.
- Resink TJ Laboratory of Signal Transduction, Department of Biomedicine, University Hospital Basel, Hebelstrasse 20, Basel CH 4031, Switzerland.
- 2016-05-19
Published in:
- Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology. - 2016
Device battery replacement
Dimethyl sulfoxide
Ethanol
Lead disconnection
Aged
Aged, 80 and over
Defibrillators, Implantable
Device Removal
Dimethyl Sulfoxide
Ethanol
Female
Humans
Male
Middle Aged
Pacemaker, Artificial
Pilot Projects
Solvents
English
AIMS
Battery exchange in pacemaker (PM) or implantable cardioverter defibrillator (ICD) devices may be occasionally problematic because of difficulties in lead disconnection procedures and risk of injuring the fragile leads. This pilot study compares ethanol and dimethyl sulfoxide (DMSO) as solvents to assist removal of leads from PM or ICD device headers in cases of stuck leads or difficulties in untightening device header screws.
METHODS AND RESULTS
Of the total number (527) of our patients requiring battery replacement due to end-of-life (EOL) warnings, conventional exchange was not possible in 34 (6.5%) due to embedding of the lead within blood-derived material. Of these, 30 (17 with PM, 13 with ICD) consented to the study and were randomly assigned to a primary attempt at lead disconnection by ethanol (n = 17) or by DMSO (n = 13). If the primary attempt failed, a secondary attempt at lead disconnection was undertaken using the alternate solvent. Ethanol was a superior solvent compared with DMSO, yielding successful disconnection at primary attempt in 88.2% (15/17) vs. 23.1% (3/13) of cases. In 8 patients in whom the primary DMSO-attempted disconnection failed, a secondary attempt with ethanol yielded success in 6 (75%) cases. Use of either ethanol or DMSO in lead disconnection was not associated with any adverse events or effects.
CONCLUSION
Ethanol has utility as a simple and inexpensive modality for lead disconnection from ICD or PM headers.
Battery exchange in pacemaker (PM) or implantable cardioverter defibrillator (ICD) devices may be occasionally problematic because of difficulties in lead disconnection procedures and risk of injuring the fragile leads. This pilot study compares ethanol and dimethyl sulfoxide (DMSO) as solvents to assist removal of leads from PM or ICD device headers in cases of stuck leads or difficulties in untightening device header screws.
METHODS AND RESULTS
Of the total number (527) of our patients requiring battery replacement due to end-of-life (EOL) warnings, conventional exchange was not possible in 34 (6.5%) due to embedding of the lead within blood-derived material. Of these, 30 (17 with PM, 13 with ICD) consented to the study and were randomly assigned to a primary attempt at lead disconnection by ethanol (n = 17) or by DMSO (n = 13). If the primary attempt failed, a secondary attempt at lead disconnection was undertaken using the alternate solvent. Ethanol was a superior solvent compared with DMSO, yielding successful disconnection at primary attempt in 88.2% (15/17) vs. 23.1% (3/13) of cases. In 8 patients in whom the primary DMSO-attempted disconnection failed, a secondary attempt with ethanol yielded success in 6 (75%) cases. Use of either ethanol or DMSO in lead disconnection was not associated with any adverse events or effects.
CONCLUSION
Ethanol has utility as a simple and inexpensive modality for lead disconnection from ICD or PM headers.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1093/europace/euv406
- PMID 27189956
- Persistent URL
- https://sonar.ch/global/documents/53450
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