Heart Disease: Lead Extraction

A pacemaker or implantable cardioverter defibrillator (ICD) deliver energy to the heart muscle through wires called leads. A lead extraction is the removal of one or more leads from inside the heart.

Leads that are placed outside the heart during open heart surgery cannot be removed during this type of procedure.

When Is a Lead Extraction Needed?

This procedure is needed when your leads are not working properly. This can be caused by:

• Damage to the inside (called a fracture) or outside of the lead.
• Large amounts of scar tissue form at the tip of the lead, causing it to need more energy to function than your pacemaker or ICD can deliver. This condition is known as "exit block."
• Infection at the site of the device and lead implant.

How Do I Prepare For This Procedure?

To prepare for the procedure, you should:

• Ask your doctor what medications you are allowed to take. Your doctor may ask you to stop taking certain medications one to five days before your test. If you have diabetes, ask your doctor how you should adjust your medications.
• Do not eat or drink anything after midnight the evening before your test. If you must take medications, drink only with a sip of water.
• When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. Leave all jewelry or valuables at home.

You will need to stay in the hospital overnight. Bring items with you (such as robe, slippers, and toothbrush) that may make your stay more comfortable. When you are able to return home, arrange for a companion to drive you home.