Lead Extraction

Treating Cardiovascular Diseases in Wisconsin and Northern Illinois

Lead extraction is performed on pacemaker or defibrillator leads that your doctor has determined need to be removed.  Over time, pacemaker and defibrillator leads may malfunction or become infected, which may require them to be removed. 

Not all malfunctioning leads must be removed, but this is determined by your doctor in consultation with you.  Lead extraction may be accomplished by several means.  Some leads may come out with a gentle tug or may need to be removed using a special snare, laser, or cautery system designed to remove leads.  Once the leads are removed, the doctor can replace them. Our doctors discuss the risks, side effects, and complications with our patients before the procedure. 

How to Prepare for a Lead Extraction Procedure

To prepare for this procedure your doctor will ask you to stop eating or drinking, usually the night before your procedure.  Your doctor will also give you instructions on what medications to stop taking and what medications to take the day of your procedure.  

Patients usually arrive several hours before the procedure so that laboratory tests, IV's, history, medication review and final skin wash can be completed prior to your procedure.  An antibiotic will be given before the start of your procedure to also help prevent infection.

Each person's situation is unique, so discuss with your doctor the expected length of time you need to take off after your procedure. 

What to Expect During a Lead Extraction Procedure

Leads may be taken out in the operating room or in a procedure room, such as the Electrophysiology Lab.  The doctors evaluate each patient on a case-by-case basis to determine the safest procedure area.  The operating and procedure room is cool and full of equipment.  The table is narrow and the staff will assist you into a comfortable position on the table.  The staff will explain all the preparations as they get you ready for the procedure. 

Most lead extraction procedures are done under general anesthesia. An anesthesiologist will talk to you before the procedure about the process and will put you to sleep before the procedure starts.

Once you are asleep, your chest will be prepared with a special antiseptic soap and surgical drape put in place.  After opening the area with the pacemaker or defibrillator, the doctor will typically use a tube (sheath) with laser to carefully burn through the scar as the sheath moves down over the lead.  If there is a lot of scarring, an electrocautery sheath may be used to carefully remove the lead from the scarred tissue.  Once the leads are removed, the doctors can put in new leads and device.  Sometimes, when you have an infection on your device and lead(s), you may need a few days of antibiotics before the new leads and device can be put back in. 

Once the procedure is complete, your incision is closed and dressed and you are taken to a recovery area to wake up.  You will be in the recovery room for about an hour.  After the recovery room you will be taken to a regular room for an overnight stay or longer, depending on your situation.

Recovery after the Lead Extraction Procedure

Most people can go home a day or so after the procedure.  You may want to take a few days off after the procedure to allow your body to heal.  You will have some special instructions on moving your arm on the same side as the pacemaker/defibrillator to assist in a safe recovery period.  After your recovery period, you can resume all normal activity.  Your doctor will make specific recommendations based on your situation. 

Most patients are a little sore after the procedure and this will gradually go away over the next few days.  Your doctor will give you some mild pain medication to reduce the soreness and will give you instructions on medications to continue or stop after your procedure.

You will need someone to drive you home from the hospital and stay with you for a couple of days just in case of any problems.  Your doctor will also instruct you on any driving restrictions after your recovery.

It is very important to keep your follow up appointments with your doctor so they can test and program the pacemaker or defibrillator to best treat your condition.

Why Choose Aurora for a Lead Extraction Procedure?

Aurora cardiovascular specialists have been extracting leads for over 10 years.  Our doctors use a variety of techniques to remove the leads as safely as possible.  Patients may be evaluated by several doctors to determine the safest plan for managing the leads.  Our staff and physicians are very experienced and work closely together to provide the most up-to-date and comprehensive care for our patients.

Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or vascular specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.