A hybrid ICD extraction approach using laser and transfemoral extraction technique.

Indications for pacemaker and implantable cardioverter defibrillator (ICD) implantations are rapidly expanding. Hence, device-related complications have increased the need for lead extraction. Lead extractions are performed percutaneously or by open surgery. We present a patient with isolated left ventricular noncompaction cardiomyopathy suffering from ICD pulse generator pocket and lead infection with aggregatibacter actinomycetem comitans bacteremia. The complete device was successfully removed by a hybrid two-step approach using excimer laser and transfemoral lead extraction technique in combination with mechanical traction via the subclavian vein. Thereby, open surgery with possible need for cardiopulmonary bypass could be avoided in this patient.