Cardiac Implantable Electronic Device (CIED) Infection & Laser Lead Extraction | MedStar Health

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Replacing a device and leads when an infection occurs

If you have a pacemaker or implantable cardioverter defibrillator (ICD) to correct an abnormal heart rhythm (arrhythmia), there may come a time when the device needs to be replaced. 

The doctors in our Electrophysiology Program have access to the latest technologies to care for patients with even the most complex arrhythmias. We’ll work with you to determine if and when your device needs to be replaced.

Signs and symptoms of CIED infection

The signs and symptoms of the pocket site include:

  • Drainage
  • Pain
  • Redness
  • Swelling
  • Ulceration (a break in the skin)
  • Warmth

Symptoms of a serious system-wide infection include fever and chills. People with deep-seated infections can experience inflammation of the heart chambers and valves, called endocarditis, and/or osteomyelitis, a serious bone infection.

If you think you have an infection, you should contact your physician as soon as possible. Studies have shown that the longer the delay in removing the infected device the greater the chance of death. Your doctor will do tests to confirm the infection. If the tests detect an infection, your doctor will discuss treatment options.

Laser lead extraction

Approximately one million pacemakers, cardiac defibrillators, and resynchronization devices are implanted worldwide each year, including more than 300,000 in the United States alone. Reliable and effective, today’s cardiac implantable electronic devices (CIEDs) can reduce patient morbidity and mortality by up to 40 percent.

However, they are not without risk, with lead or device infection topping the list. Within three years of implantation, 1 in 20 CIED patients will develop an infection, the risk escalating the longer the device is in place.

Treatment 

Laser lead extraction is a surgical technique to remove a pacemaker or defibrillator and the wire or wires from inside the heart. Extraction usually takes four to six hours under general anesthesia. The length of hospitalization is one-to-two days, with recovery time like that of a pacemaker or cardiac defibrillator implantation. Electrophysiology specialists typically replace the infected device with the latest generation of a leadless pacemaker after the infection has cleared. Studies show that complete lead and device extraction is the only way to thoroughly eradicate a CIED infection.

Potential risks of the procedure include fracture of the lead, dissection of a blood vessel, major hemorrhage requiring transfusion, or cardiac trauma; actual occurrences are rare.

Complex lead management teams

MedStar Health complex lead management teams are located at MedStar Washington Hospital in D.C. and MedStar Union Memorial Hospital in Baltimore. They are composed of specially trained cardiac electrophysiologists and cardiac surgeons. For more information about the MedStar Health laser lead extraction program, please call:

Doctors Hadadi and Thomiades pose for a photo in a cardiac electrophysiology suite at MedStar Health.(l to r) Cardiac Electrophysiologists Cyrus Hadadi, MD, and Athanasios Thomaides, MD photo at MedStar Washington Hospital Center
Doctors Sidhu and Harrison pose for a photo in a cardiac electrophysiology lab at MedStar Health.(l to r) Cardiac Electrophysiologist Sunjeet Sidhu, MD, and Cardiac Surgeon Rachel Harrison, MD at MedStar Union Memorial Hospital

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Our locations

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MedStar Union Memorial Hospital

201 E. University Pkwy.
Baltimore, MD 21218

MedStar Franklin Square Medical Center

9000 Franklin Square Dr.
Baltimore, MD 21237

MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Southern Maryland Hospital Center

7503 Surratts Rd.
Clinton, MD 20735

MedStar Georgetown University Hospital

3800 Reservoir Rd. NW
Washington, DC, 20007

MedStar Montgomery Medical Center

18101 Prince Philip Dr.
Olney, MD 20832

Additional information

Electrophysiology Program

We are leaders in developing and using the latest procedures and technologies to treat heart rhythm disorders, and our cardiac electrophysiology laboratory is one of the most sophisticated in North America.

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Have general questions for our heart and vascular program? Email us at AskMHVI@medstar.net. If you have clinically-specific questions, please contact your physician’s office.