As heart patients continue to live longer with devices such as pacemakers and implantable cardiodefibrillators (ICDs), the need for replacing the electrical leads that connect the heart to the devices continues to grow. But even as lead extractions become more common, they remain serious procedures that demand careful evaluation by experienced physicians and an understanding by the patient of the options and risks involved, says Bruce Wilkoff, MD, Director of Cardiac Pacing and Tachyarrhythmia Devices at Cleveland Clinic. "The devices attached to the leads arent meant to last forever," Dr. Wilkoff says. "The leads, though, are intended to last for more than one device." In some cases, a lead that no longer works can be left in place and a new lead can be put in elsewhere to provide the necessary link between heart and device, Dr. Wilkoff says, adding that its not ideal to leave a useless wire in the heart, but in some cases the risk of removing it outweighs the potential complications of just leaving it alone.