Percutaneous extraction of a severed and frayed permanent pacing lead

From the point of view of established practice, redundant permanent pacing leads have been abandoned or extracted using various catheter-based procedures. An unusual complication was caused by failed surgical lead extraction resulting in electrode severing and wire unbraiding with subsequent induction of electric interaction between the metallic, noninsulated part of the lead fragment and the defibrillating electrode. This interaction was sensed and detected by the ICD system. A modified catheter-based extraction procedure is described.