Pacemaker or Defibrillator Laser Assisted Lead Removal (Extraction)

Pacemaker or Defibrillator Laser Assisted Lead Removal (Extraction)

The image below illustrates placement of pacemakers and implantable cardiac defibrillators (ICD). One thing these devices have in common are leads (insulated wires with electrodes at the tip). Pacemaker and ICD leads become attached to the structure of the heart by scar tissue. Sometimes pacemaker and ICD leads need to be removed from the heart. A damaged (fractured) lead or infected lead is a reason it might be necessary to remove leads from the heart. The original pacemaker or ICD implant site is usually the incision site for removal. Once the lead is exposed at the incision site, a laser sheath is threaded over the damaged lead. As the laser sheath is advanced over the lead it uses light energy to vaporize and remove the scar tissue from around the lead. Once the lead is free of the scar tissue, it can be removed through traction. This procedure can take about 4 to 6 hours to complete.

Laser Lead Extraction

The illustration compares an ICD and a pacemaker. Figure A shows the location and general size of an ICD in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest. Figure B shows the location and general size of a pacemaker in the upper chest. The wires with electrodes on the ends are inserted into the heart through a vein in the upper chest.

Image Source: National Heart, Lung, and Blood Institute (NHLBI)