What is laser lead extraction?
Laser extraction is a safe and effective way to remove implanted pacemaker and defibrillator leads. Lead extraction can become complicated, because scar tissue will often form around the lead, binding it to the lining of the heart and blood vessels. In order to be removed, the scar tissue must be separated from the lead. Laser extraction uses ultraviolet rays to vaporize scar tissue surrounding the lead. This procedure is less likely to damage or tear the lining or heart and blood vessels, and is less time consuming and therefore less traumatic to the patient.
How Do I Prepare For Lead Extraction Procedure?
Ask your doctor what medications you are allowed to take. Your doctor may ask you to stop certain medications one to five days before your test (such as aspirin-containing products). If you have diabetes, ask your doctor how you should adjust your medications. Do not eat or drink anything after midnight the evening before your test. If you must take medications, drink only with a sip of water. When you come to the hospital, wear comfortable clothes. You will change into a hospital gown for the procedure. You will need to stay in the hospital overnight. Bring items with you (such as robe, slippers, and toothbrush) that may make your stay more comfortable. When you are able to return home, arrange for a companion to bring you home. Leave all jewelry or valuables at home.
When is a pacemaker or defibrillator lead extraction needed?
Lead systems which fail or provide inadequate function may consume precious venous access or myocardial surface. Larger lead systems, such as those utilized for ICDs, are incompatible with multiple intravenous leads. Furthermore, abandoned leads have the potential to interfere with the function of newer lead systems by creating electrical chatter or energy shunting. The safer and more effective technology of lead extraction also allows broader use of the procedure. Current Indications for pacemaker and ICD Lead Removal # Damage to the inside (called a fracture) or outside insulation of the lead # Large amounts of scar tissue form at the tip of the lead, causing it to need more energy to function than your pacemaker or ICD can deliver. This condition is known as “exit block.” # Infection at the site of the device and lead implant: extraction is needed to eliminate the infection # Lead migration # Need to make room for new leads (in case of nonfunctioning leads) specially if the vein is narrow or occluded