Heart Lead Extraction (cont.)

What to Expect During a Lead Extraction:

A lead extraction procedure takes about two to six hours to perform.

  • You will be given a hospital gown to wear.
  • You will lie on a bed and the nurse will start an intravenous (IV) line in your arm so that medications and fluids can be given during the procedure.
  • Your chest and groin area will both be shaved and cleansed with an antiseptic solution. Sterile drapes are used to cover you from your neck to your feet to prevent infection. It is important that you keep your arms and hands down at your sides and not disturb the drapes. A soft strap will be placed across your waist and arms to prevent your hands from coming in to contact with the sterile field.
  • The nurse will connect you to several monitors.
  • You may feel nervous. You will be given a drug through your IV that will make you sleep throughout most of the procedure. Your doctor and nurse will be with you and if you are uncomfortable or need anything during the procedure, let your nurse know.
  • The lead extraction can be performed through one of two sites:
    • Subclavian vein (in the upper chest) -- most frequently used. An incision is made in the upper chest over the subclavian vein.
    • Femoral vein (in the groin) -- used when the subclavian approach cannot be performed. A small puncture (instead of an incision) is made in the groin over the femoral vein.
  • The doctor will numb the site. A sheath (plastic, hollow tube) is placed in the vein and guided to the tip of the lead (where the lead attaches to the heart). The sheath helps to hold the heart muscle in place while removing the lead.
  • A laser or special electrosurgical sheath is used to deliver energy to remove scar tissue from the lead. You will be in a light sleep during this part of the procedure. You may feel the pulling as the leads are removed, but you should not feel pain.
  • New leads may be implanted (placed in your heart) during this procedure or at a later date. This will depend on the reason your current leads are being removed. Discuss this with your doctor.

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