Percutaneous Extraction of Chronically Implanted Left Ventricular Lead Aided by Telescopic Sheaths Spares Patient Major Cardiac Surgery

A 70-year-old patient sustained a severe pocket infection of a biventricular pacemaker system implanted 4 years ago. Patient opted for a percutaneous approach to lead extraction over open heart surgery. However, use of special locking stylets to facilitate lead traction was hampered by inability to insert the stylets due to mechanical lumen blockage and/or uncoiling and fracture of lead conductors. Hence, the procedure was finally carried out successfully only with use of telescoping sheaths, which facilitated extraction by freeing leads from multiple adhesions along their intravascular and intracardiac course, sparing patient major open cardiac surgery which would have been the only alternative should the percutaneous technique have failed.