Lead extraction
What is a lead extraction?
This procedure is conducted under general anaesthetic. The cardiologist will re-open the site where your pacemaker was originally placed and remove the generator.
If the leads are being extracted due to infection then it may be necessary to insert temporary pacing wires until the infection has cleared.
When you wake you may have a bulky dressing in place. This will stay in place for 24 hours. The thin dressing beneath this will be removed when specified by the cardiologist.
You should not move your arm above your shoulder for two weeks after the procedure (or as advised by your cardiologist).
How long does the procedure take?
How long will I be at the clinic for?
How do I prepare for a lead extraction procedure?
Provide informed consent
Your doctor will explain your procedure to you and answer any questions you may have. You will then be asked to sign a consent form.
You will find a copy of the consent form below. Please download and read this document in advance of your visit. Your doctor will discuss this with you on your arrival, if they have not already done so.
Lead Extraction Consent
If you have access to a printer, then please print your consent form and bring it with you on the day of your procedure. Otherwise we will provide you with a copy on the day to sign with your doctor.
If you have already signed the consent in your doctor’s rooms, then please disregard this instruction.
Contact us the day before your procedure
Please ring us between 12 noon and 3pm on the day before your procedure [tel: 02 9382 0700] to confirm your time of arrival, fasting and medication instructions. Please ring on a Friday if your procedure is on a Monday.
If you have special needs (these are outlined in the Before my visit patient guide) please let us know one week in advance of your visit.
Fasting
All patients attending Eastern Heart Clinic are fasted prior to their procedure. Please follow the fasting instructions that are given to you when you ring us the day prior to your procedure.
Instructions:
- All patients must cease solid food six hours before their admission time
- All patients must cease clear fluids two hours before their admission time (note: clear fluids are NOT cloudy or milky drinks)
- From two hours before your admission – nil by mouth
For example, if your admission time is 7:00 am (please tailor this to your admission time)
- You can eat food up until 1:00 am
- You can have clear fluids (water, black tea/coffee, clear juice etc) up until 5:00 am
We will confirm the time of your procedure and when you need to start fasting when you call the clinic the day before your procedure (please refer to our detailed instructions in the Before my visit patient guide).
Medications
Patients prescribed Warfarin
If you take the medication Warfarin you will need to consult with your referring cardiologist who will advise you if you need to stop taking your Warfarin three days before your procedure. Your cardiologist may also advise that you need to take a substitute anticoagulant (blood thinner). It is very important that you do not stop taking your Warfarin until you have discussed this with your cardiologist.
Patients prescribed Lasix
On the day of your procedure:
If your procedure is scheduled for before 12:00 pm: Withhold your Lasix and bring in your tablets so staff can give them to you after your procedure
If your procedure is scheduled for after 12:00 pm: you may take your Lasix
Patients with diabetes
If you are prescribed insulin we suggest you take half your regular insulin dose on the day of your procedure. Remind the booking staff that you are on insulin and we will attempt to schedule your procedure as early as possible.
Insulin dependent (IDDM): You should take half (½) of your regular insulin dose (please bring in insulin)
Non-insulin dependent (NIDDM) – tablet controlled: You should continue your medication as normal
Non-insulin dependent (NIDDM) – diet controlled: Fast as per the instructions above
Other medications
Oral Sodium Glucose Inhibitors
If you take any of the following medication – Forxiga, Xigduo, Qtern, Jardiance, Jardiamet, Glyxambi, Steglatro, Segluromet, Steglujan – please contact Eastern Heart Clinic for instructions prior to your procedure.
Aspirin, Plavix, Prasugrel, Ticagrelor, Pradaxa, Apixaban, Rivaroxaban
Your cardiologist will provide advice regarding if and when to stop other medication. All other medications include Aspirin, Plavix, Prasugrel, Ticagrelor, Pradaxa, Apixaban, Rivaroxaban.
Skin and nails
There are no special requirements before your procedure in terms of skin care, so just shower or bath as usual. However, please do not wear nail polish to your appointment.
What to bring
Please bring your current medications as well as any blood results. Please read our patient guide Before my visit for other items to bring with you on the day, and for how to prepare for your procedure.
Can I drive (or fly) afterwards?
Please note that some airlines place restrictions on patients flying after certain procedures. Our staff will be able to provide you with guidance and advice.
What do I need to do after discharge?
You can read more about your discharge care in our patient guides: Day of my procedure and After my visit.