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Updated: Sep 16, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

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Local Anesthetic-Related Methemoglobinemia During Cardiac Device Implantation; A Retrospective Registry: The LAMDA

Nazif Yalçın1, Fatih Kahraman2, Mehmet Ali Astarcıoğlu2

  • 1Department of Internal Medicine, University of Health Sciences, Bursa Sehir Training and Research Hospital, Bursa, Türkiye.

Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir
|July 11, 2025
PubMed

Insights

Prilocaine used in Implantable Cardioverter-Defibrillator (ICD) and Cardiac Resynchronization Therapy (CRT) procedures can cause methemoglobin elevation. However, clinically significant methemoglobinemia is rare, with factors like BMI, hemoglobin, and creatinine playing a role.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Clinical Chemistry

Background:

  • Implantable Cardioverter-Defibrillator (ICD) and Cardiac Resynchronization Therapy (CRT) are crucial for managing heart failure and arrhythmias.
  • Prilocaine is a local anesthetic sometimes used in these procedures, but its potential to cause methemoglobinemia requires investigation.

Purpose of the Study:

  • To determine the frequency of methemoglobin development after ICD/CRT procedures using prilocaine.
  • To identify factors associated with methemoglobin elevation in these patients.

Main Methods:

  • Retrospective analysis of data from 64 patients undergoing ICD/CRT procedures.
  • Measurement of pre- and post-procedure methemoglobin levels.
  • Correlation analysis with clinical factors including creatinine, hemoglobin, and BMI.

Main Results:

  • Significant increase in methemoglobin levels and decrease in oxygen saturation observed in the first hour post-procedure.
  • Elevated methemoglobin correlated with higher creatinine and lower BMI and hemoglobin levels.
  • No significant association found with ALT levels.

Conclusions:

  • While prilocaine can cause methemoglobin elevation during ICD/CRT procedures, clinically significant methemoglobinemia is uncommon.
  • Methemoglobin elevation is significantly associated with pre-existing patient factors like BMI, hemoglobin, and creatinine levels.
Abstract

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