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, Faiz Subzposh, Avi Fischer, James O. Coffey, Sandeep R. Gangireddy, Samir Saba, Suneet Mittal, Aysha Arshad, Ryan Michael O'Keefe, Charles A. Henrikson, Peter BelottRoy M. John, Laurence M. Epstein

    Research output: Contribution to journalArticle

    34 Scopus citations

    Abstract

    Background 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. Objective Data regarding the safety and feasibility of extraction of Riata implantable cardioverter-defibrillator leads are limited. Methods We performed a retrospective study of patients undergoing extraction of Riata/Riata ST leads at 11 centers. Results 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%). Conclusion 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.

    Original languageEnglish (US)
    Pages (from-to)1613-1618
    Number of pages6
    JournalHeart Rhythm
    Volume11
    Issue number9
    DOIs
    StatePublished - Sep 2014

    Keywords

    • ICD
    • Lead extraction
    • Lead management

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine
    • Physiology (medical)

    Fingerprint Dive into the research topics of 'Multicenter experience with extraction of the Riata/Riata ST ICD lead'. Together they form a unique fingerprint.

  • Cite this

    Maytin, M., Wilkoff, B. L., Brunner, M., Cronin, E., Love, C. J., Grazia Bongiorni, M., Segreti, L., Carrillo, R. G., Garisto, J. D., Kutalek, S., Subzposh, F., Fischer, A., Coffey, J. O., Gangireddy, S. R., Saba, S., Mittal, S., Arshad, A., O'Keefe, R. M., Henrikson, C. A., ... Epstein, L. M. (2014). Multicenter experience with extraction of the Riata/Riata ST ICD lead. Heart Rhythm, 11(9), 1613-1618. https://doi.org/10.1016/j.hrthm.2014.05.014