Abstract 20266: Riata Lead Failure in Pediatric and Congenital Heart Disease Patients
Introduction: ICD lead failures are relatively common with higher failure rates identified in pediatric and congenital heart disease (CHD) patients. Our study aim was to determine the rate and timing of Riata® lead failure in children and patients with CHD.
Methods: This was a retrospective, multicenter cohort study of patients ≤21 years of age and/or with CHD who underwent implantation of a Riata® or Riata® ST lead between 2002 and 2009. The incidence and timing for electrical failure and conductor coil externalization (CCE) were determined.
Results: The study included 47 patients and 52 leads from 4 centers. Five patients had 2 leads each. The median (IQR) age at implant and last follow-up was 14.8 (11.5-18.7) and 22.3 (18.1-27.3) years. Primary prevention was the indication in 81% and 53% were male. The Riata® lead characteristics were single coil in 60% and active fixation in 55%. Over a median lead age of 6.9 (6.1-10.4) years, CCE was reported in 14% (6/42) and electrical failure in 49% (21/43). CCE was located proximal to the proximal coil and in the pocket in 2 patients each. Electrical failure consisted of non-physiological noise/artifact in 71% (15/21). There were no reported failed appropriate shocks due to changes in electrical lead properties. A total of 5 patients experienced CCE and electrical failure, with CCE diagnosis preceding in 2 patients and simultaneously diagnosed in 2 patients. The 5- year actuarial rate of CCE was 13% (95%CI 5-28%) and 27% (95%CI 16-43%) for electrical failure. Overall, 14 (27%) leads were abandoned, 14 (27%) were extracted, 16 (31%) are still functional and the status of the remaining 8 is unknown.
Conclusions: The rate of Riata® lead electrical failure was significantly high in this population of pediatric and congenital patients. The rate of CCE was comparable to published data. Only a third of these leads have remained functional over this study’s follow-up period.
Author Disclosures: C.A. Escudero: None. S. Islam: None. D. Mah: None. C.Y. Miyake: None. E.A. Stephenson: None. M.J. LaPage: None. J. Atallah: None.
- © 2016 by American Heart Association, Inc.