Leads Removal

I am having my pacemaker changed next Tuesday, and there is a strong possibility that my leads will be removed also. Could you please tell me how this is done? Is it done as open heart surgery or does the same physician removes the leads at the time of the pacemaker change? I would appreciate your help. I have lupus also that may complicate my life. Thank you. Ariela

6 Comments

Lead Removal

by SMITTY - 2009-12-12 03:12:18

Hi Ariela,

I had my 9 year old pacemaker replaced in Oct and went through this possibility. I asked my doctor how this was done and I recall the reply I got was something like this. After pacemaker was removed and the leads disconnected, a sheath (flexible tube) is placed in the vein where the leads are located and threaded over the lead that is attached to the heart and then guided to the tip. The sheath helps to free the lead of any scar tissue holding it in place and to help when pulling it out. The lead is then removed by pulling it out.

Sometimes, if the lead has been place for a long time and is firmly embedded in tissue and can't be removed by the sheath, a different type sheath that has a laser attached is used. The laser can be used to cut away any remove scar tissue around the lead where it is attached to the heart muscle or vein.

He made it sound as if either procedure was no more complicated than the initial lead insertion. However, since I was able to keep my original leads I can't say if that is true or not.

Good luck,

Smitty

depends

by Tracey_E - 2009-12-12 07:12:03

If your leads have been in there for more than a year, it's usually a more complicated procedure to pull them out, the laser Smitty described.

Why are they talking about removal? They can usually tell by testing if your existing leads are functioning or not. If they aren't, there are two schools of thought. Some doctors leave well enough alone and try to add the new lead on top of the old ones. Others want to start with a clean slate and remove what's there before inserting new ones.

There are not a lot of doctors with a lot of experience removing leads with the laser sheath. I have a bad lead now and need a new battery in the next few months. If the surgeon thinks what I have needs to be removed (I'm hoping to add the new one to what I have now), he will not be doing it, I will seek out someone who specializes in it. It's a fairly new procedure and there are not a lot who have done it enough times to be what I'd consider expert. The procedure itself is not that bad and has a high success rate, but when there are complications they are generally serious and require open heart surgery.

I'd be asking a lot more questions before they put you under!

Lead removal

by lenora - 2009-12-13 07:12:30

Actually there are a great many interventional cardiologists who remove leads with the laser. It's not a new procedure at all. As a cardiac nurse I've never seen complications requiring open heart surgery. Have a good talk with your cardiologist before the procedure and ask him specifically how he'll remove the leads if necessary and what if any complications are possible.

Lasers!!!!

by roadbiker - 2009-12-13 12:12:49

My doctor answered this question for me two days ago. I was asking all about my new implant and one of the questions was about leads... How are the anchored, if they can be pulled out easily after they are healed over and how they remove them to change them. His answer was "LASER!" and he seemed VERY confident and knowledgable about it. So there ARE doctors out there that are very comfortable with the laser process and do have much successful experience. Complications do happen taking them out but probably about the same percentage as when they put them in. AINT bein BIONIC a trip??? RS

lead removal

by papaknight - 2009-12-22 02:12:46

I just went through teh lead removal procedure and my doctor who supposedly was very experienced reoved one failed medtronic led using what he called the "traction method". He got one lead out but the older St Judes lead that had failed 4 years ago brok with "gentle traction" at the svc coil. I'm having a heck of a time finding out whats left and where it is. We did make it clear that we wanted all components removed to be returned to us and got the medtronics ICD and lead but no one can find the Riata [piece that broke off. Try to find out just how much experience your physician has and if it will be done in an operating rooomor an P lab. Also, tell them you want the removed parts, you can always send them to the company if they want them.The cleveland clinic has a gret site covering this. Best of luck to you
PapaKnight

lead removal

by dwelch - 2010-01-21 05:01:38


When I asked i was told about what I guess folks here are calling the sheath method. I have a spare lead in there that broke on the first replacement. One lead is 22 years old the other is what 15 years old, both are doing just fine. I am a tall/big guy so the doc said three is okay but if another one goes four will be too many so they will remove one or two of them. I asked specifically if this is open heart and they said no. But you know these things have already doubled my life span, so if they have to cut me in half and sew me back up to keep me alive another 10,20,30 years, well so be it.

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