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Europace 2009 11(10):1317-1322; doi:10.1093/europace/eup249
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org.

ICD

Making post-mortem implantable cardioverter defibrillator explantation safe

Sune B.E.W. Räder1,*, Volkert Zeijlemaker2, Steen Pehrson1 and Jesper H. Svendsen1,3,4

1 Department of Cardiology, 2013, The Heart Centre, Rigshospitalet, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark; 2 Medtronic, Bakken Research Center, Maastricht, The Netherlands; 3 Department of Medicine and Surgery, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark; 4 The Danish National Research Foundation Centre for Cardiac Arrhythmia, Copenhagen, Denmark

Aims: The aim of this study is to investigate whether protection with rubber or plastic gloves during post-mortem explantation of an implantable cardioverter defibrillator (ICD) offers enough protection for the explanting operator during a worst-case scenario (i.e. ICD shock).

Methods and results: We investigated the insulating properties of rubber and plastic gloves (double layer) within the first 60 min exposure (mimicking the maximum time of an explantation procedure) to saline (simulating the effects of body fluids on the gloves). For latex gloves, we measured an increase in voltage up to 68.1 V (P < 0.0001), for neoprene a maximum voltage of 5.3 V (P = 0.245), and for plastic a voltage of 2.3 V within the first hour. If the exposure time to fluid did not exceed 50 min, a double pair of intact gloves made of latex, neoprene, or plastic constituted such a large resistance that the resting voltage over the operating person would not exceed 50 V.

Conclusion: The use of intact medical gloves made of latex, neoprene, or plastic eliminates the potential electrical risk during explantation of an ICD. Two gloves on each hand offer sufficient protection. We will recommend the use of neoprene gloves.

Key Words: ICD, Explantation, Safety, Gloves, Resuscitation

* Corresponding author. Tel: +45 35 45 96 70, Fax: +45 35 45 44 37. Email: sbewr{at}dadlnet.dk

Manuscript submitted 24 April 2009. Accepted after revision 10 August 2009.


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