Clinical presentations included device erosion (41%), cellulitis or abscess (35%), and endocarditis (24%). Fifty-nine patients (87%) were followed up for more than 1 year, and 9 patients were lost to follow-up after 1 to 10 months after 1-stage contralateral device exchange, with no new identi- fied CIED infections. Additional experience with 1-stage con- tralateral device exchange is needed, however, before it can be recommended for routine use. There are reports of successful implantations of previously implanted devices from either deceased patients or from the same patient with a prior PPM infection.78,80 Mansour and coworkers78 described 17 patients with a previously infected PPM who underwent successful implantation (at a new site and after resterilization) without relapsing infection. The practice of reusing CIEDs after sterilization is not advocated, however. Recommendations for New CIED Implantation After Removal of an Infected CIED Class I 1. Each patient should be evaluated carefully to determine whether there is a continued need for a new CIED. (Level of Evidence: C) 2. The replacement device implantation should not be ipsilateral to the extraction site. Preferred alternative locations include the contralateral side, the iliac vein, and epicardial implantation. (Level of Evidence: C) Class IIa 1. When positive before extraction, blood cultures should be drawn after device removal and should be negative for at least 72 hours before new device placement is performed. (Level of Evidence: C) 2. New transvenous lead placement should be delayed for at least 14 days after CIED system removal when there is evidence of valvular infection. 