First of all, leads are often reused when one device is changed out for another. If they cannot be reused, they are often capped and left in place. In some cases, a lead extraction may be performed to remove the lead from your body through either the subclavian vein in the upper chest, or through the femoral vein (groin area) if the subclavian approach isn't possible. In that case, an incision (subclavian) or small puncture (femoral vein) is made in the skin. A hollow, plastic tube called a sheath is inserted into the vein and guided to the tip of the lead. The sheath helps hold the heart muscle in place while the lead is removed. An electrosurgical laser is then used to remove scar tissue from the leads just before they are pulled out. People are usually in a light sleep for this procedure and may feel the leads as they are being pulled out, but it shouldn't be painful.