Call for Public Comment

Public Comment: 2026 HRS Expert Consensus Statement Update on CIED Lead Management & Extraction

Public comment window: September 17 - October 12

HRS invites public comments on the draft 2026 HRS Expert Consensus Statement Update on CIED Lead Management and Extraction, developed in collaboration with ACC, AHA, ASA, APHRS, EHRA, IDSA, LAHRS, PACES, and STS. This update reflects advances since 2017 and provides practical, evidence-based recommendations across transvenous, leadless, and extravascular systems.

HOW TO COMMENT

1. Download the Draft Manuscript and Public Comment Form.

2. Enter your comments in the spreadsheet and save your completed form.

3. Email the completed form to [email protected] with the subject line Lead Management Comments.

DOCUMENT FOCUS:

• Incorporates new CIED technologies (leadless and non-vascular options) and their implications for lifetime lead management.

• Updates CIED infection prevention (pre-incision systemic antibiotics; selective antibacterial envelope use in higher-risk cases).

• Clarifies diagnostic pathways for suspected infection, including when to use TEE and when 18F-FDG PET/CT can improve accuracy.

• Provides guidance for tricuspid valve interventions when leads cross the valve.

• Emphasizes standardized, multidisciplinary extraction programs and timely referral to experienced centers.

• Recommends remote monitoring for all CIED systems to detect electrical abnormalities early.

• Highlights lead selection/implant techniques and minimizing unnecessary lead burden to facilitate future management.

• Addresses tricuspid regurgitation related to lead position and recommends post-implant surveillance.