Removal of monofilamental and multifilamental temporary pacing leads following open-heart surgery: occurrence of arrhythmias.

This study compared multifilamental and monofilamental temporary pacing leads in a clinical series of 83 patients who underwent valve replacement or coronary artery bypass grafting. The leads were used in the bipolar mode and were implanted into the outer layers of the right ventricular myocardium. The force required for wire removal (newtons), and the arrhythmias which occurred during removal were monitored. During electrode removal, 48% of the patients had transient arrhythmias (46% with monofilamental and 51% with multifilamental leads). The most common was a single ventricular premature contraction. In one case, wire removal caused non-sustained ventricular tachycardia. All the arrhythmias subsided spontaneously. There was no statistical difference between results of the two leads. The force needed for removal was monitored directly by applying force via a graduated spring; they were equal in both groups (2.6 newtons). Both electrode types behaved similarly during wire removal, and the spiral tail of the monofilamental lead did not provoke arrhythmias.