Entire Removal of Screw-In Pacing Leads 3 Years after Implantation

Objective: To report that screw-in type pacing leads can be removed by screw retraction even after a significant anchoring period. Patient: A 78-year-old woman who visited our hospital for skin erosion over a pacemaker that had been implanted 3 years previously and had migrated from the subclavicular area to the axilla. Methods: Culture revealed a local staphylococcus infection. We placed a new pacemaker system in the contralateral (right) side, removed the old one, inserted a straight type stylet into the leads, and turned the rotator counterclockwise. Results: An image monitor confirmed complete retraction of the ventricular lead screw and partial retraction of the atrial lead screw, and we were able to pull out both leads without any resistance. The patient was given antibiotics and discharged 2 days after the surgery. No wound infection was evident at a 3-month follow-up examination. Conclusion: When a screw-in type pacemaker with a retractor must be removed long after its implantation, screw retraction should be tried before resorting to a removal kit or open heart surgery.