Patients should seek evaluation for CIED infection by cardiologists or infectious disease specialists if they develop fever or bloodstream infection for which there is no initial explanation. (Level of Evidence: C) Class III 1. Percutaneous aspiration of the generator pocket should not be performed as part of the diagnostic evaluation of CIED infection. (Level of Evidence: C) Baddour et al Cardiovascular Device Infections 463 Management CIED removal is not required for superficial or incisional infection at the pocket site if there is no involvement of the device. Seven to 10 days of antibiotic therapy with an oral agent with activity against staphylococci is reasonable. Complete removal of all hardware, regardless of location (subcutaneous, transvenous, or epicardial), is the recom- mended treatment for patients with established CIED infec- tion.37,38,70 This includes cases in which a localized pocket infection occurs in the absence of signs of systemic infection. Complete removal of hardware is needed because infection relapse rates due to retained hardware are high.1,37,38,71,72 Erosion of any part of the CIED should imply contamination of the entire system, including the intravascular portion of leads, and complete device removal should be performed. Complete CIED removal should be performed when pa- tients undergo valve replacement or repair for infective endocarditis, because the CIED could serve as a nidus for relapsing infection and subsequent seeding of the surgically treated heart valve. An epicardial system should be consid- ered if a new CIED is required after valve surgery with initial CIED removal. The first issue to address in the treatment of CIED infections is the approach to hardware removal. As newer technologies have emerged and the experience has grown, percutaneous lead extraction has become the preferred method for removal of CIED hardware. 