A new pacing lead extraction system (VascoExtor, VascoMed, Germany) with a universally applicable locking stylet was used over a period of 12 months to extract 25 permanent pacemaker leads (mean implantation time 3.9 +/- 3.8 years) in 16 patients who had pacemaker infection (n = 13), lead dysfunction (n = 2), or before an automatic defibrillator implant (n = 1). With use of this system, we were able to successfully and safely remove 24 of 25 chronic pacing leads (96%) in 15 of 16 patients (93%) with sole use of the locking stylet in 81%, and with use of an array of ancillary tools in the remaining 19% of patients.