This interview with Mikhael El-Chami, MD, explores the key updates in the 2026 HRS Expert Consensus Statement on CIED lead management and extraction, highlighting how advances in extraction tools over the past decade have reshaped clinical practice and informed updated recommendations. The discussion outlines how the new guidelines differ from prior versions and other society statements. Dr El-Chami also addresses the more controversial topics encountered during the consensus process and provides insight into how the committee navigated differing expert opinions to arrive at balanced, evidence-based recommendations.