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Stepwise Progression and Successful Extraction of a Completely Transected EMBLEM S-ICD Model 3501 Lead.

Junji Morita1, Yuhei Kasai1, Takayuki Kitai1

  • 1Department of Cardiology Sapporo Cardiovascular Clinic Sapporo Hokkaido Japan.

Journal of Arrhythmia
|June 8, 2026
PubMed
Summary

A patient experienced a lead fracture in their S-ICD device. A novel technique using a silk-suture extension and Byrd sheath enabled safe lead extraction, highlighting a simple strategy for lead removal.

Keywords:
lead extractionlead fracturesubcutaneous implantable cardioverter defibrillator

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Area of Science:

  • Cardiology
  • Medical Device Technology
  • Surgical Procedures

Background:

  • Subcutaneous implantable cardioverter-defibrillators (S-ICDs) offer transvenous lead-free therapy.
  • Lead complications, such as transection, can occur despite device advancements.
  • Complete lead transection poses a challenge for device management and patient safety.

Purpose of the Study:

  • To describe a case of complete lead transection in an S-ICD.
  • To present a successful and simple strategy for the safe extraction of a transected S-ICD lead.
  • To illustrate the potential for stepwise lead injury during S-ICD lead failure.

Main Methods:

  • A 33-year-old male patient with an EMBLEM S-ICD (Model 3501) presented with complete lead transection.
  • Secondary-vector sensing was confirmed to be preserved.
  • A silk-suture extension was utilized in conjunction with a Byrd sheath for lead extraction.

Main Results:

  • Complete lead transection of the S-ICD lead was diagnosed.
  • The lead was successfully and safely extracted using the described silk-suture extension and Byrd sheath technique.
  • The extraction procedure confirmed a stepwise lead injury pattern.

Conclusions:

  • Complete S-ICD lead transection is a potential complication.
  • A simple, stepwise extraction strategy using readily available tools like silk-suture extension and a Byrd sheath can be effective for safely removing transected S-ICD leads.
  • This case highlights a viable approach to managing S-ICD lead integrity issues.