Stanford Cardiac Arrhythmia Service

The Lead Extraction Procedure

Lead extraction is a minor surgical procedure performed in the cardiac catheterization laboratory. Your physician will discuss the procedure with you beforehand. Once you and your physician have discussed the procedure and you’ve had any questions answered, you’ll be required to sign an informed consent form.

You won’t be allowed to eat or drink for eight hours prior to the procedure. Please consult with us several days before your procedure to determine whether or not you should discontinue any of your usual medications.

During the procedure, you’ll lie flat on a table for the duration. Your upper chest and both groins will be scrubbed and shaved (if needed) and you’ll be covered with sterile sheets. You’ll receive some sedation intravenously to help you relax during the procedure.

The extraction can be performed wither through a small incision in your upper chest, or by accessing the femoral artery through your groin area. The physician will give you a local anesthetic at the incision site. After the area is numb, the physician will use fluoroscopy (x-ray monitors) to guide a sheath through your vein to the tip of the lead, where it attaches to the heart. The sheath helps hold the heart muscle in place when we remove the lead.

Your physician will use a laser or special electrosurgical sheath to deliver a pulse of energy to remove scar tissue from the lead and allow it to be extracted. If a new lead nees to be implanted, we will do so either during the procedure, or at a later time.

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