Arrhythmias & electrophysiologyGuideline or statement
Cardiac implantable electronic device upgrades and downgrades: a Clinical Consensus Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Asia Pacific Heart Rhythm Association (APHRS), Canadian Heart Rhythm Society (CHRS), Heart Rhythm Society (HRS), and the Latin American Heart Rhythm Society (LAHRS)
- Clinical consensus statement
Recommendations
As issued by the authors
Framework for screening patients for device upgrade, pre-procedural planning, procedural strategies (vascular access techniques, ipsilateral and contralateral options) and when extraction to gain access may be appropriate
Advice on framing an ethical discussion with patients and carers on available options
Original publication
Cardiac implantable electronic device upgrades and downgrades: a Clinical Consensus Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Asia Pacific Heart Rhythm Association (APHRS), Canadian Heart Rhythm Society (CHRS), Heart Rhythm Society (HRS), and the Latin American Heart Rhythm Society (LAHRS). Europace. Published 11 December 2025. doi:10.1093/europace/euaf252
Summarised from the published abstract; every number is checked against it