Implantable devices, which include pacemakers and implantable cardioverter defibrillators, are small generators that are placed under the skin in the left or right upper chest area. They are attached to small wires called leads that carry current back to the heart.

When a permanent pacemaker or implantable cardioverter defibrillator is implanted, the expectation is that the device will remain in the patient’s body for the rest of their life. But, as with all medical devices, there are circumstances that may require the removal of the system.

The body’s natural response to a foreign object, such as a pacemaker, is to form scar tissue surrounding the leads that run through the blood vessels down to the heart. The longer the device is inside the body, the more scar tissue there will be, making removal difficult. Old leads cannot remain in the body as they would interfere with new devices. If the physician is unable to remove the lead with gentle pulling, a special laser extraction device is used.

With the extraction device, a controlled dose of laser energy is applied to break up the scar tissue and free the lead so it can be pulled out.

The laser energy produces pulsed bursts of UV light energy that gently dissolve the fibrous tissue into tiny, microscopic particles which are easily absorbed into the bloodstream.