Making post-mortem implantable cardioverter defibrillator explantation safe.
OBJECTIVE
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).


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.


CONCLUSIONS
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.
Räder
Sune B E W
SB
Department of Cardiology, 2013, The Heart Centre, Rigshospitalet, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. sbewr@dadlnet.dk
Zeijlemaker
Volkert
V
Pehrson
Steen
S
Svendsen
Jesper H
JH
D001344:Autopsy / Q000295:instrumentation* / Q000379:methods; D020878:Device Removal / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D004556:Electric Injuries / Q000209:etiology* / Q000517:prevention & control*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D017575:Gloves, Protective; D006801:Humans