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" ... Significant controversy remains on how to manage externalized ICD leads that have normal electrical testing. At the HRS Scientific Sessions this past May, Dr. Roger Carillo advocated transesophageal echocardiographic imaging of externalized leads and systemic anticoagulation if thrombus is visualized, but this strategy has not been widely adopted. He and others have warned that extraction of this lead can be technically challenging with potential for hazard to the patient. In today’s notice, FDA “caution[s] against routine removal of leads without careful evaluation of benefits and risks to the individual patient.” ... "