2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction
September 14, 2017—The document, developed in collaboration with the ACC, AHA, APHRS, ASA, EHRA, IDSA, LAHRS, PACES, and STS, is intended to help clinicians in their decision-making process for managing leads and builds on the 2009 Transvenous Lead Extraction: Heart Rhythm Society Expert Consensus on Facilities, Training, Indications, and Patient Management. It provides practical clinical guidance in the broad field of lead management, including lead extraction.
This document was reaffirmed on May 1, 2022 and will be formally assessed again in 2027.
The statement focuses on identifying the presence of lead malfunction, deciding on whether to abandon or to extract a lead that is no longer clinically necessary or at higher risk for failure, offering guidance on whether a cardiovascular implantable electronic device (CIED) is involved in an infectious process, providing recommendations on when lead extraction should be considered, and discussing specific clinical considerations for patient management when a lead extraction is performed.
The document includes specific recommendations in the following areas:
- Lead Survival
- Existing CIED Lead Management
- Indications for Lead Extraction (Infectious)
- Indications for Lead Extraction (Noninfectious)
- Outcomes and Follow-up
The document features a clinician summary (an educational derivative product of the full document) and a pocket card, developed in partnership with Guideline Central and available across multiple platforms, including print, electronic media, and the Guideline Central mobile app. Visit www.guidelinecentral.com to access the pocket card.