Lead Management

The Heart Rhythm Society (HRS) recommends removal of pacing and defibrillation leads under class I and II indications. Spectranetics helps physicians when removal is necessary in Cardiac Lead Management.

SLS® II - The laser sheath is intended for use as an adjunct to conventional lead extraction tools in patients suitable for transvenous removal of chronically implanted pacing or defibrillator leads constructed with silicone or polyurethane outer insulation.

LLD®, LLD® E, LLD EZ® - The LLD is intended for use in patients suitable for transvenous removal of chronically implanted pacing or defibrillator leads having an inner lumen and using a superior venous approach.

HRS Class I Indications for Extraction of Cardiac Leads*:

• Sepsis or endocarditis with documented infection of any intravascular portion of pacing system
• Pocket infection when the intravascular portion of the lead system cannot be aseptically separated from the pocket
• Life-threatening arrhythmias secondary to a retained lead fragment
• A retained lead that poses immediate or imminent physical threat to the patient
• Clinically significant thromboembolic events caused by a retained lead or lead fragment
• Obliteration or occlusion of all usable veins with the need to implant a new transvenous pacing system
• A lead that interferes with the operation of another implanted device

HRS Class II Indications for Extraction of Cardiac Leads*:

• Non-functional leads in young patients*
• Leads preventing access to the venous circulation for newly required implantable devices
• Localized pocket infection, erosion, or chronic draining sinus not involving the transvenous portion of the lead system (when the lead can be cut through a clean incision that is totally separated from the infected area)
• An occult infection for which no source can be found and for which the pacing system is suspected
• Chronic pain at the pocket or insertion site not manageable by medical or surgical technique without lead removal
• A lead that interferes with the treatment of a malignancy
• A traumatic injury to the entry site of the lead for which the lead may interfere with reconstruction of the site

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