Prospective evaluation of cinefluoroscopy and chest radiography for Riata lead defects: implications for future lead screening

Abstract

Cinefluoroscopy appears to be more sensitive than CXR for the detection of Riata cable extrusion. Interpretation of CXR by a radiologist with education in lead defects correlates highly with cinefluoroscopy with very high specificity. Depending on available resources for screening, CXR may be a reasonable alternative to cinefluoroscopy. Multidisciplinary collaboration across specialties (radiology and electrophysiology) can lead to improved diagnostic capability and thus the potential for enhanced quality of care.

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

“…Prevalence of CE ranged from 11% to 43% ( Figure 2A). 6,[10][11][12][13][15][16][17][19][20][21][22]25 Based on random effects modeling, the overall rate of CE was 23.1% (95% CI 19.0%-27.6%). In most but not all of these 13 studies, an average lead dwell time was reported (range 3.5-6.2 years).…”

“…[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][26][27][28] Based on random effects modeling, the overall rate of EF was 6.3% (95% CI 4.7%-8.2%). Significant heterogeneity was again observed with I 2 = 89.507.…”

“…7,10,11,15,17,19,21,22 This rate ranged from 0% to 9.2%. In a random effects analysis, the rate of EF in the absence of externalization was 2.7% (95% CI 1.4%-5.2%; Figure 3B).…”

“…6,[10][11][12]15,17,[19][20][21][22]25 In the setting of known CE, the prevalence of EF ranged from 0% to 50.0%. In a random effects analysis, the rate of EF in the presence of CE was 17.3% (95% CI 11.2%-25.9%; Figure 3A).…”

“…Nine studies reported prevalence of CE by the number of high-voltage coils. 11,12,[15][16][17][19][20][21][22] In these studies, the number of implanted dual-coil Riata leads (n = 1235) outnumbered the single-coil leads (n = 651). In 4 cases, there were fewer than 3 subjects with single-coil leads.…”