Optimal Management of Riata Leads with No Known Electrical Abnormalities or Externalization: A Decision Analysis

Abstract

Overall there were minimal differences in survival with monitoring versus active lead management approaches. There is no evidence to support fluoroscopic screening for externalization of Riata or Riata ST leads.

Occurrence and extraction of implantable cardioverter-defibrillator leads with conductor externalization

“…The rate of completely faulty leads remains low [13,14]. In the present group high voltage circuit failure stayed low, however the response of such leads during high-voltage intervention and measurements conducted with low-voltage current do not provide any clear-cut answers [15]. The hitherto conducted analyses suggest that further damage of externalized leads might occur during high-voltage intervention and therefore result in a short-circuit which would mean unsuccessful intervention.…”

2017 HRS expert consensus statement on cardiovascular implantable electronic device lead management and extraction

“…Several investigators have developed extraction risk models that consider factors such as lead dwell time, number of leads, patient age, and other comorbidities. 62,140,212,[240][241][242][243][245][246][247][248][249][250][251][252] Age is often an important consideration for lead extraction. Higher risk of lead malfunction and longer exposure to potential complications from abandoned leads are often cited as a justification for lead extraction in younger patients.…”

Cable externalization and electrical failure of the Riata family of implantable cardioverter-defibrillator leads: A systematic review and meta-analysis

“…41 This parallels the variable clinical practice related to Riata leads. Our analyses provide additional information for providers who continue to manage patients with indwelling Riata leads by further clarifying the risks of lead failure with or without evidence of CE.…”