Fidelis defibrillator leads have been recalled in 2007 because of a high fracture rate, exposing patients to inappropriate shocks, and to re-interventions. There are currently no guidelines on the management of patients with functional Fidelis leads. The dilemma is of particular relevance when the patient undergoes a generator replacement, as this offers an opportunity to perform concomitant lead revision. Our aim was to evaluate long-term outcome with different strategies of Fidelis lead management at generator replacement.