Step 5: Harvest the Wires
After creation of an appropriately sized pocket, the J-wires must be dissected out at the pre-pectoral fascia layer. The operator must first palpate where the wires are under the superior lip of the pocket, and then using Metzenbaum scissors with opening motions, bluntly dissect away the tissue until the metal wires can be clearly visualized. Then the closed Metzenbaum scissors can be inserted behind the wires to help backstop the wires as their back ends are fed into the pocket to harvest them. Now that the wires are harvested, the operator can proceed with the rest of the CIED implant per normal protocol starting with insertion of the first peel-away sheath (Video 5).