Safe Use of a Drill for Managing Frozen Leads During Pacemaker Replacement

Frozen leads are an uncommon complication occurring in 4% to 12.5% of pacemaker replacements. Although the use of drills has been proposed as a solution, no detailed technique has been described to date.

We encountered a case of ventricular lead entrapment during generator replacement 9 years after pacemaker implantation. Conventional methods including silicone plug removal, vibration of the pin plug, and even the application of a bone cutter failed to resolve this issue. The lead was successfully released using a drill without causing any damage.

Our method involved approaching the header from multiple angles with the drill, enabling safe release of the frozen lead. Innovative drilling techniques are required as the device design evolves.

When managing a frozen lead, it is essential to employ the drill with appropriate modifications and technique.