Format

Send to

Choose Destination
Pacing Clin Electrophysiol. 2012 Dec;35(12):1498-504. doi: 10.1111/pace.12010. Epub 2012 Oct 4.

Fluoroscopic and electrical assessment of a series of defibrillation leads: prevalence of externalized conductors.

Author information

1
Cardiology Department, Royal Victoria Hospital, Belfast, Northern Ireland, United Kingdom. vivek.kodoth@belfasttrust.hscni.net

Abstract

INTRODUCTION:

Insulation defects with externalized conductors have been reported in the St. Jude Riata(®)  family of defibrillation leads (St. Jude Medical, Sylmar, CA, USA). The objective of the Northern Ireland Riata(®)  lead screening program was to identify insulation defects and externalized conductors by systematic fluoroscopic and electrical assessment in a prospectively defined cohort of patients. We sought to estimate the prevalence, identify risk factors, and determine the natural history of this abnormality.

METHODS:

All patients with a Riata(®)  lead under follow-up at the Royal Victoria Hospital were invited for fluoroscopic imaging and implantable cardioverter-defibrillator lead parameter checks. Fluoroscopic images were read independently by two cardiologists and the presence of externalized conductors was classified as positive, negative, or borderline.

RESULTS:

One hundred and sixty-five of 212 patients with a Riata lead were evaluated by fluoroscopy and lead parameter measurements. The mean duration after implantation was 3.98+/-1.43 years. After screening 25 (15%) patients were classified as positive, 137 (83%) negative, and three (1.8%) borderline. Time since implantation (P = 0.001), presence of a single coil lead (P = 0.042), and patient age (P = 0.034) were significantly associated with externalized conductors. The observed rate of externalized conductors was 26.9% for 8-French and 4.7% for 7-French leads. No leads that were identified prospectively with externalized conductors had electrical abnormalities. Seven of 25 (28%) patients had a defective lead extracted by the end of this screening period.

CONCLUSION:

A significant proportion (15%) of patients with a Riata lead had an insulation breach 4 years after implantation. High-resolution fluoroscopic imaging in at least two orthogonal views is required to identify this abnormality.

PMID:
23035735
DOI:
10.1111/pace.12010
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center