Key points about lead extraction
• Lead extraction may be necessary for infection, malfunction, or lead-related complications.• The procedure uses specialized tools and is performed by trained electrophysiologists or cardiac surgeons.
• It carries a higher risk profile than lead implantation, especially with older or scarred leads.
• Most patients recover well with appropriate planning and follow-up care.
• Not all leads need to be removed—decisions are made case by case.
Overview of lead extraction
Lead extraction involves the removal of pacing or defibrillator wires that are no longer safe or functional. While often straightforward, the procedure can be complex due to scar tissue that develops around older leads, requiring specialized tools and experienced providers.Candidates for lead extraction
Lead extraction may be recommended for patients who:• Have an infection involving the leads or device pocket.
• Are experiencing complications from a fractured or malfunctioning lead.
• Have multiple or redundant leads causing vein blockage.
• Are undergoing a system upgrade or no longer need the device.
Preparation for lead extraction
• Imaging (like chest X-ray or CT) and blood tests are often done prior to the procedure.• Antibiotics may be given before and after the procedure to prevent or treat infection.
• The procedure is done under general anesthesia in a specialized cardiac care setting.
• Plans for emergency surgical backup are typically in place due to the potential for serious complications.
Recovery from lead extraction
• Patients are monitored closely in the hospital after the procedure.• Most patients stay at least one night, though longer stays may be needed for infection management.
• Soreness at the site and mild fatigue are common for a few days.
• Activity restrictions may be advised for a short period post-procedure.
• Ongoing follow-up is important, especially if a new device is implanted afterward.
Risks for lead extraction
While lead extraction is often successful, risks can include:• Damage to blood vessels, heart wall, or valves.
• Bleeding that may require transfusion or emergency surgery.
• Infection or worsening of an existing infection.
• Complications from anesthesia or related to underlying medical conditions.