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Multicenter experience with extraction of the Riata/Riata ST ICD lead
Journal article   Peer reviewed

Multicenter experience with extraction of the Riata/Riata ST ICD lead

Melanie Maytin, Bruce L Wilkoff, Michael Brunner, Edmond Cronin, Charles J Love, Maria Grazia Bongiorni, Luca Segreti, Roger G Carrillo, Juan D Garisto, Steven Kutalek, …
Heart rhythm, v 11(9), pp 1613-1618
Sep 2014
DOI: https://doi.org/10.1016/j.hrthm.2014.05.014
PMID: 24854215
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Aged Arrhythmias, Cardiac - therapy Defibrillators, Implantable - adverse effects Device Removal - methods Equipment Design Equipment Failure Feasibility Studies Female Follow-Up Studies Humans Male Middle Aged Pericardial Effusion - etiology Pericardial Effusion - surgery Retrospective Studies Time Factors Treatment Outcome
In November 2011, the Food and Drug Administration issued a class I recall of Riata and Riata ST implantable cardioverter-defibrillator leads. Management recommendations regarding the recall have remained controversial. Data regarding the safety and feasibility of extraction of Riata implantable cardioverter-defibrillator leads are limited. We performed a retrospective study of patients undergoing extraction of Riata/Riata ST leads at 11 centers. Between July 2003 and April 2013, 577 Riata/Riata ST leads were extracted from 577 patients (Riata 467, [84%]; Riata ST 89, [16%]). Complete procedural success achieved in 99.1%. The cohort was 78% men, with a mean age of 60 years and a mean left ventricular ejection fraction of 34% ± 14%. The mean implant duration was 44.7 months (range 0-124.6 months). The majority of leads extracted were for infection (305 [53.0%]) and 220 (35.7%) for lead malfunction. Evaluation for lead integrity was performed in 295 cases. Of these, 34.9% were found to have externalized cables. Implant duration was significantly longer in leads with externalized cables (P < .0001). No difference in lead integrity was noted between Riata and Riata ST leads (11.7% vs. 17.7% failure; P = .23). Among leads in which cable externalization was noted, laser sheaths were used more frequently (P = .01). Major complications included 3 superior vena cava/right ventricular perforations requiring surgical intervention with 1 death 12 days after the procedure and 1 pericardial effusion requiring percutaneous drainage (0.87%). Extraction of the Riata/Riata ST leads can be challenging, and leads with externalized cables may require specific extraction techniques. Extraction of the Riata/Riata ST leads can be performed safely by experienced operators at high-volume centers with a complication rate comparable to published data.

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37 citations in Web of Science
43 citations in Scopus

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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