Illustration of the “lead inverting stitch”. A. Purse-string suture applied around the perforating lead. B. Atrial lead-tip severed with heavy scissors followed by inversion of the remnant atrial lead fragment and surrounding scar beneath the tightened purse-string. Note: the epicardial pacing lead is already in place. C. Cross-section illustration of the severed and inverted atrial lead following tightening of the purse string around the lead (i.e., “lead inverting stitch”).