Pacemaker and ICD Lead Extraction
For years, patients across the country have been referred to Providence Saint Joseph Medical Center for lead extraction, a complex procedure requiring an expert team of physicians. Providence Saint Joseph Medical Center’s Pacemaker and ICD Lead Extraction Program was founded in 1989, and Saint Joseph is a leading provider and high-volume center that is equipped to handle even the most high-risk and complicated procedures.
What is Lead Extraction?
If you have a cardiac device such as a pacemaker or implantable cardioverter defibrillator (ICD), you may require a complex procedure called lead extraction. Although these cardiac devices are designed for long-term or indefinite use, certain circumstances may require the leads, or wires, that deliver energy to the heart to be removed and replaced.
The most common reason for requiring a lead extraction procedure is an infection surrounding the cardiac device, or within the bloodstream or heart itself. In most cases, these infections cannot be treated solely with antibiotics and the leads must be removed to successfully rid the body of the infection. Another common reason for lead extraction is lead malfunction, breakage or damage, in which case the leads need to be removed and replaced.
At Providence Saint Joseph Medical Center our team is led by Dr. Raymond H.M. Schaerf, a board-certified thoracic surgeon serving as the Director of the Lead Management Center and Chief of Thoracic Surgery. Dr. Schaerf is one of only a handful of physicians in the world with the expertise and the state-of-the-art equipment required to perform lead extraction surgery.
To date, Dr. Schaerf has performed nearly 5,000 lead extractions, making him one of the most experienced lead extraction specialists in the world. He is considered a pioneer of his field having developed leading-edge techniques that utilize lasers and mechanical tools and eliminating heart infections without open chest surgery. He has been a phase one investigator for the FDA for many of the tools used in lead extraction.
Dr. Schaerf speaks five languages, including English, German, Spanish, French and Yiddish.
Lead Extraction Surgery: What to Expect
All lead extractions are performed in the hospital under general anesthesia, and generally take one to four hours to perform. During the procedure, Dr. Schaerf makes a small incision into the chest to remove the implanted device and the connected leads. After removing the leads from the vein and body, new replacement leads may be implanted.
Depending upon the reason for the extraction, recovery time varies. For patients who suffered from broken or damaged leads, they are generally able to leave the hospital after one day following their procedure. For cases involving infection, patients typically must remain in the hospital for three to four days for close monitoring and antibiotic treatment.
While most patients are able to return to work shortly after being discharged from the hospital, it is recommended that patients restrict their day-to day-activities for three days following the procedure.
Know the Risks
Lead extraction is a complex procedure that only a few physicians in the world are able to perform. Due to the nature of leads, which run through veins to the heart, scar tissue forms alongside them in the body, attaching them to the heart and walls of blood vessels. This makes them fairly challenging to remove, and the level of difficulty increases the longer the leads have been in place. If leads have been in place for many years, a specialized tool such as a laser may be required to safely remove them from the wall of the heart and blood vessels.
Another risk involved in lead extraction procedures is the tearing of heart tissue, a rare event which requires immediate open-heart surgery. Due to the low, but possible, risk of heart tissue tearing, it is critical that lead extractions are performed by experts in state-of-the-art facilities, such as those at Providence Saint Joseph Medical Center.