Chronic atrial lead explantation using a staged percutaneous laser and open surgical approach

We report a staged approach to the explantation of a passive fixation atrial lead 4 years after implantation in a patient with extracardiac J wire protrusion. The body of the lead, from the venous entry site to the proximal electrode, was freed from extensive fibrous binding using an investigational Excimer laser lead extraction sheath. The distal end and J wire were freed and the lead was removed at thoracotomy. This staged approach offered a safe and effective method for the removal of a heavily fibrosed chronic endocardial lead.