Pacemaker/ICD Lead Extraction or Revision

What is pacemaker ICD lead extraction or revision?

Pacemakers and implantable cardioverter defibrillators (ICD) both use wires called "leads" to send electrical signals to the heart. Depending on the type of device, there may be one, two or three lead wires. Over time, the leads may stop working properly due to damage within the wire itself, or because of scar tissue build-up around the lead. Infections can also develop where the lead or the cardiac device has been implanted. In these cases, the entire device and all leads must be removed and/or replaced. 

Lead extraction is a delicate procedure requiring highly skilled surgical experience. The goal is to gently "pull" the lead away from tissue in which it is embedded, or where it is attached to the heart. While the surgery is considered high risk, there are advanced tools such as lasers that can help free the lead from surrounding areas with minimal damage and bleeding.

The entire process of extraction may take two to six hours, depending on how many leads you have and how long they’ve been implanted, or how much tissue has built up around them. In most cases, the pacemaker or ICD leads (or the entire device) are replaced in the same surgery.

As with any invasive procedure, there are risks such as bleeding or a cardiac event during the operation. Your doctor will discuss all of the risks as well as the removal options available to you.

The Lankenau Heart Institute has one of the most experienced pacemaker/ICD lead management teams in the region.