A 67-year-old woman with a biventricular automatic implantable cardioverter defibrillator (ICD) for nonischemic cardiomyopathy (ejection fraction 10%-15%) was admitted for fevers and a wrist infection. Blood cultures revealed methicillin-sensitive Staphylococcus aureus that persisted for 2 weeks despite antibiotics. Transesophageal echocardiography showed a vegetation on the ICD lead with preserved valvular function. She was scheduled for removal of her biventricular pacemaker/ ICD system. The use of an Excimer laser (Spectranetics Corporation, Colorado Springs, CO) was planned for extraction of 4 intracardiac leads (described below). Written consent from the patient was obtained.
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