Consensus document on management of cardiac implantable electronic de­vice leads and lead extraction

Abstract

New expert consensus document is a result of cooperation of 10 worldwide scientific societes, including HRS and EHRA, updates knowledge and recommendations on management of cardiac implantable electronic device leads and lead extraction. The definition of extraction clinical success was changed limiting the residual part of the lead left in cardiovascular system to 4 cm. Significant part of the document is dedicated to diagnosis of lead failure and its differential diagnosis with other reasons which cause a lead malfunction. New precise definition of different examples of infective complication of CIED from pocket erosion to CIED endocarditis were established. Antibiotic therapy is necessary after all extractions due to infective complication but its longevity should be form 10 days to 6 weeks or more depending on the final diagnosis. All infective indications for lead extraction except for superficial incisional infection belongs to class I indications. Numerous indications for lead extraction due to non-infective indications were simplified and class of recommendation has been lowered. Periprocedural management of patients has been described in details. Risk factors of complications and long term mortality were listed.