Get the lead out
Removing broken or infected pacemaker leads is a delicate art.
Several million Americans rely on a pacemaker to keep their hearts beating at a steady clip or an implantable cardioverter-defibrillator (ICD) to shock it back into an even rhythm if it veers out of control. The business end of these devices isn't the small generator tucked between the shoulder and chest but the thin wires that stretch from the generator to the heart. These wires, called leads (pronounced LEEDS), are the Achilles' heel of pacemakers and ICDs. Leads can break, the insulation around them can crack, and they can become infected. One-quarter or more of ICD leads fail within eight years; pacemaker leads are a bit more durable.
It's impossible to fix broken, failing, or obsolete leads. Instead, they must be replaced. Doing this isn't easy, but in centers where lead replacement is done often, the procedure is effective and safe.