Volume 14, Issue 12, Pages e503-e551 (December 2017) 2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction  Fred M. Kusumoto, MD, FHRS, FACC, Mark H. Schoenfeld, MD, FHRS, FACC, FAHA, CCDS, Bruce L. Wilkoff, MD, FHRS, CCDS, Charles I. Berul, MD, FHRS, Ulrika M. Birgersdotter-Green, MD, FHRS, Roger Carrillo, MD, MBA, FHRS, Yong-Mei Cha, MD, Jude Clancy, MD, Jean-Claude Deharo, MD, FESC, Kenneth A. Ellenbogen, MD, FHRS, Derek Exner, MD, MPH, FHRS, Ayman A. Hussein, MD, FACC, Charles Kennergren, MD, PhD, FETCS, FHRS, Andrew Krahn, MD, FRCPC, FHRS, Richard Lee, MD, MBA, Charles J. Love, MD, CCDS, FHRS, FACC, FAHA, Ruth A. Madden, MPH, RN, Hector Alfredo Mazzetti, MD, JoEllyn Carol Moore, MD, FACC, Jeffrey Parsonnet, MD, Kristen K. Patton, MD, Marc A. Rozner, PhD, MD, CCDS, Kimberly A. Selzman, MD, MPH, FHRS, FACC, Morio Shoda, MD, PhD, Komandoor Srivathsan, MD, Neil F. Strathmore, MBBS, FHRS, Charles D. Swerdlow, MD, FHRS, Christine Tompkins, MD, Oussama Wazni, MD, MBA  Heart Rhythm  Volume 14, Issue 12, Pages e503-e551 (December 2017) DOI: 10.1016/j.hrthm.2017.09.001 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Applying Class of Recommendation and Level of Evidence to clinical strategies, interventions, treatments, or diagnostic testing in patient care (Halperin et al. Circulation 2016;133:1426–1428). Heart Rhythm 2017 14, e503-e551DOI: (10.1016/j.hrthm.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Management of suspected CIED infection. *Refer to text for specific recommendations depending on microbiology. Antimicrobial therapy should be at least 4–6 weeks for endocarditis (4 weeks for native valve, 6 weeks for prosthetic valve or staphylococcal valvular endocarditis). If lead vegetation is present in the absence of a valve vegetation, 4 weeks of antibiotics for Staphylococcus aureus and 2 weeks for other pathogens is recommended. †Usually the contralateral side; a subcutaneous ICD may also be considered. **2010 AHA CIED Infection Update distinguishes between pocket infection and erosion (Baddour et al. Circulation 2010;121:458–477). Heart Rhythm 2017 14, e503-e551DOI: (10.1016/j.hrthm.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Management of suspected pocket infection. *See text for examples. Heart Rhythm 2017 14, e503-e551DOI: (10.1016/j.hrthm.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 4 Management of bacteremia without evidence of CIED infection. *Important to distinguish between blood stream infection and contamination in bacteremia involving skin flora. Heart Rhythm 2017 14, e503-e551DOI: (10.1016/j.hrthm.2017.09.001) Copyright © 2017 Heart Rhythm Society Terms and Conditions