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2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction

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Abstract

The 2017 HRS Expert Consensus Statement on Cardiovascular Implantable Electronic Device Lead Management and Extraction, 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 document. It provides practical clinical guidance in the broad field of lead management, including lead extraction.

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

Recommendations

For information on the recommendations of this guideline, please see the full statement from HRS.

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