Having Lead Extraction
Lead extraction is the removal of wires from your heart. The wires are part of an implanted cardiac device. This is a small machine put into your chest that helps your heart keep a normal rhythm.
What to tell your healthcare provider
Let your healthcare provider know if you are pregnant or think you may be pregnant. The imaging used during the procedure uses radiation. This may be a risk to a baby. Your healthcare provider may give you a pregnancy test to make sure you aren’t pregnant.
Tests before your procedure
You may have some tests before your procedure. These might include:
Electrocardiogram (ECG), to check your heart rhythm
Echocardiography (Echo), to look at heart anatomy and function
Venogram, to look at the veins around the device
Blood tests, to check your overall health
Getting ready for your procedure
You may need to not eat or drink before midnight of the day of your procedure. Follow instructions about what medicines to take before the procedure. Don’t stop taking any medicine unless your healthcare provider tells you to do so.
On the day of your procedure
Your procedure will be done by a cardiologist. This is a doctor who specializes in heart diseases. He or she will work with a team of specialized nurses and technicians. The surgery can be done in several ways. Ask your doctor about the details of your surgery. The procedure takes 2 to 6 hours. In general, you can expect the following:
You will likely have general anesthesia, medicine that allows you to sleep through the surgery. You won’t feel any pain during the surgery. In some cases, you may instead have medicine to help you relax.
A healthcare provider will watch your vital signs, like your heart rate and blood pressure, during the surgery.
If needed, skin in the area of surgery may be shaved.
The team makes a cut (incision) in your shoulder or groin.
The team makes a small hole in a blood vessel. He or she puts a tapered tube called a sheath through this hole.
The team guides the sheath to the correct place in your heart.
Next, the team removes the leads from the heart using the sheath. A variety of methods and tools can be used, depending on your specific situation.
The team will carefully watch you during the procedure. If complications occur, you may need to have immediate open-heart surgery.
The team will remove the leads and sheath through the blood vessel. In some cases, they also place new leads at this time.
The team will close and bandage the site where they inserted the sheath.
After your procedure
After surgery, you will be taken to a recovery room. Nurses will check your breathing, heart rate, and blood pressure. They will also watch your heart rhythm. You may be given pain medicine if you need it. If the incision was made in a vein in your leg, you will need to lie flat for several hours after the procedure. You should not bend your legs. This will help prevent bleeding. You will need a follow-up chest X-ray to check your heart and lungs after the procedure. You’ll likely need to stay in the hospital 1 or more nights.
Recovering at home
Follow all the instructions your healthcare provider gives you. When you go home, go back to your normal activities when you feel able. Avoid vigorous activity until your doctor says you are ready.
You may need to have stitches (sutures) removed a week or so after the procedure. Make sure to keep all of your follow-up appointments.
When to call your healthcare provider
Call your healthcare provider right away if you have any of these:
Swelling that gets worse
Bleeding or fluid leaking from the incision that gets works
Fever of 100.4°f (38.0°c) or higher
March 21, 2017
Buch E, Boyle NG, Belott PH. Cardiology patient page: pacemaker and defibrillator lead extraction. Circulation. 2011;123:e378-e80., Garlitski AC. Cardiac implantable electronic device lead removal. UpToDate., Wilkoff BL, Love CJ, Byrd CL, et al. Transvenous lead extraction: Heart Rhythm Society expert consensus on facilities, training, indications, and patient management. Heart Rhythm. 2009;6:1085-1104.
MMI board-certified, academically affiliated clinician,Turley, Ray, BSN, MSN