What to Expect
We perform implant, extraction and replacement of pacing leads.
Leads are electrical wires insulated with silicon or polyurethane which connect a pacemaker or defibrillator to the heart chambers.
Procedures - Implant
Leads are usually inserted into a vein near the collarbone and advanced to a heart chamber where they are secured in place. They are most often implanted in the right heart chambers but occasionally need placement in the left side of the heart to provide cardiac resynchronization therapy (CRT) to patients who suffer from congestive heart failure (CHF). For the CRT patients the leads are advanced through a vein within the heart called the coronary sinus. Occasionally leads need to be placed on the outside of the heart by means of a minimally invasive surgical procedure which can be performed using the da Vinci robot system. Standard pacemaker lead implants are usually performed under local anesthesia, but may be general anesthesia if the leads are placed on the outside of the heart.
Procedures - Extraction
Leads can become infected, fracture or dislodge and stop working. These occurrences are rare, however if this does happen, they will need to be removed and replaced. Removal of an implanted lead is called ‘lead extraction’. It is performed with various specialized tools including specific laser equipment. This procedure is usually performed under general anesthesia.