Lead Extraction and Management | Loyola Medicine

Lead Extraction and Management

Management and Care for Implanted Heart Devices

Lead extraction and management, also called lead removal, is a critical component of your overall care if you are a patient with a pacemaker or ICD (implantable cardioverter defibrillator). 
 
A lead is a thin, flexible wire that is threaded through a vein in the chest and connected inside the heart. The leads deliver an electrical shock to the heart muscle from a pacemaker or ICD, which helps keep the heart beating at a normal rhythm. Most people with pacemakers and ICDs have two or three leads implanted; and in order to function properly, the leads must be monitored and managed throughout your care.
 
Highly skilled cardiac electrophysiologists at Loyola Medicine are expert at fixing and replacing the devices that control abnormal heart rhythm. Lead extractions may be necessary for the following reasons:

  • Infection
  • Lead fracture
  • Scar tissue formation
  • Vein blockage by a clot

Why Choose Loyola for Lead Extractions and Lead Management?

Loyola serves as a major regional and national referral center for the treatment of atrial fibrillation, offering treatment options often unavailable elsewhere. Our skilled team of leading electrophysiologists, advanced practice nurses, technical staff, imaging experts and other professionals provides an integrated approach to the diagnosis and treatment of a variety of rhythm disturbances and their associated underlying conditions.

What to Expect with Lead Extraction and Lead Management

Cardiologists at Loyola approach the management and extraction of leads with great detail and care. They are skilled at managing your expectations and performing the procedure with precision. 
 
There are two approaches to lead extraction:

  • Subclavian approach — The most frequently used approach, in which the leads are extracted through an incision in the upper chest over the subclavian vein
     
  • Femoral approach — Used when the subclavian approach is not possible; the leads are removed through a small puncture in the groin over the femoral vein

During lead extraction, a medical tube is placed in your vein. The tube is pulled over the lead and guided to the tip where the lead attaches to your heart. Your doctor will remove scar tissue and the damaged lead.
 
Whenever possible, your cardiologist will implant new leads during the extraction procedure. There are times, however, when the physician will opt to re-implant the leads at a later date. For example, if there is an infection at the lead site, this infection will have to heal before the cardiologist can safely perform a new lead placement.

What are the Risks of Lead Extraction and Lead Management?

Lead extraction and management is generally considered to be very safe. However, as with any surgical procedure there are risks, which can include:

  • Heart complications
  • Internal bleeding
  • Tear in your vein or heart

Your doctor will review your risks with you and develop a treatment plan that is right for you.