Implantable devices such as pacemakers and cardioverter defibrillators (ICDs) are used to treat arrythmias. These devices have wires called leads that carry electrical current from the device to your heart. Although the leads are meant to remain in your body permanently, they may need to be removed.
During pacemaker or defibrillator lead extraction, your UPMC electrophysiologist removes the leads. Our defibrillator and pacemaker lead extraction teams include multiple cardiovascular specialists who have extensive experience performing this complex minimally invasive procedure.
Although they perform different functions, both devices consist of a pulse generator — a small metal box that contains a battery and electronic circuits.
One end of the wire leads connects to the pulse generator — typically run through a vein to the right side of your heart — and delivers a small amount of electric current when needed. The electricity causes your heart to beat.
To ensure the leads stay in the right place in your heart, the surgeon performing the implantation attaches them to your heart using very small screws or tines. In response — as part of the healing process — scar tissue forms on the leads and at the tip where it connects to your heart.
Although they are meant to remain in your body permanently, occasionally pacemaker/defibrillator leads need to be removed. In pacemaker or defibrillator lead extraction, your UPMC electrophysiologist removes the leads — the wires that carry electrical current from your implantable device to your heart — through a small incision during a minimally invasive procedure.
Reasons for lead extraction include:
Because lead extraction is a complex procedure that carries some surgical risk, your provider will let you know if you are a candidate for lead extraction.
You may be a candidate for lead extraction if you are upgrading your implantable cardiac device, develop an infection, have a problem with your leads, or your leads are recalled by the manufacturer.
Lead extraction procedures are minimally invasive. However, they still carry risks. Complications could arise that require open surgery. Potential complications include:
Lead extraction is a safe procedure when performed by an experienced team of experts. However, because the leads often become attached to your vein walls and heart, lead extraction carries risks and requires more skill than it does to implant them. Removing the attached leads can damage the lead, veins, or heart.
On the day of your lead extraction procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home.
You will need to stay in the hospital overnight after your procedure. You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. If you have an infection, you may need to stay in the hospital until the infection is gone. You should arrange for someone to drive you home from the hospital after you are discharged.
Lead extraction takes between 1 to 6 hours to complete. You will need to stay in the hospital for at least one night after your procedure.
You will receive medication through an IV to make you sleep during the procedure. After you are asleep, your UPMC electrophysiologist will:
When the sheath stops advancing, the electrophysiologist:
Because lead extraction typically involves only a small incision, you may be able to go home the day after the procedure. If you have an infection, you may need to remain in the hospital or at a skilled nursing facility until the infection is gone.
Your doctor will let you know when you can resume everyday activities and will schedule a follow-up appointment for you.
You should call your doctor if you are experiencing any unusual symptoms, including:
After lead extraction, many people receive new leads or a new device and can resume normal activities.
When performed by a skilled and experienced team, lead extraction success rates may exceed 90 percent. However, your doctor will discuss your condition and expected success rate with you before your procedure.
At UPMC, our defibrillator and pacemaker lead extraction teams — all of whom have extensive experience with this complex procedure — include:
Our expertise in lead extraction is unique in Pennsylvania due to:
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
