Abstract 13416: Continuing Riata® Lead Failures- Results of Third Year of Fluoroscopic Screening
Introduction The Northern Ireland Riata® Lead Screening Programme commenced in August 2010 and aimed to prospectively identify the prevalence of externalized conductors in our patients with Riata® leads. From our prior studies with fluoroscopic screening we have observed a failure rate of 15% at one year and 19% at 2 years respectively. We report the results of our third year of prospective screening.
Methods All patients in our ICD database with Riata, Riata ST or Riata® ST Optim leads were identified and invited for screening involving high resolution fluoroscopic imaging in two orthogonal views and ICD lead parameter checks. Three cardiologists examined the images independently to assess for the presence of externalized conductors. The leads were classified by their fluoroscopic appearance as positive, negative or borderline.
Results Two hundred and twelve patients had a Riata® lead implanted in our centre. Subsequently 49 patients have died, 22 had the lead extracted and 4 were excluded from follow up. Of a possible 137 patients, 22 did not attend and therefore 115 leads were screened at year three. The average time from lead implant to screening was 5.4±1.3 years and mean interval from year 2 to year 3 screening was 296 ± 62.1 days. After screening, two new positives were identified (plus 13 previously classified as positive), eight new borderline (plus 1 previously identified) and 91 patients (79.1%) were negative for externalized conductors. ICD electrical parameters were within the normal ranges in all patients.
Conclusion After three years of prospective lead screening we have shown a cumulative lead failure rate of 20.8% and an incidence of 4.7% per year, at an average of 5.4 years post implant. There still remains a lack of professional consensus as to the optimum assessment and management of Riata® leads with externalized conductors and no electrical abnormalities.
- © 2012 by American Heart Association, Inc.