title: Failure to deliver therapy by a Riata Lead with internal wire externalization and normal electrical parameters during routine interrogation.
abstract: We present a case of failure to deliver a shock by a St. Jude Medical defibrillator involving a Riata lead that was discovered incidentally while the device was attempting to deliver inappropriate therapy. Routine interrogation, including high voltage (HV) impedance, failed to reveal any abnormality. Failure to deliver therapy was confirmed during DFT testing, which revealed extremely low HV impedance only while attempting to deliver therapy. Fluoroscopy indicated moderate externalization of internal wires. This case highlights an under-recognized issue with St. Jude Medical systems, namely the possibility that therapy may not be delivered despite the presence of normal electrical parameters during routine surveillance.
authors.affiliation: Department of Electrophysiology, Henry Ford Hospital, Detroit 48202, Michigan, USA.
authors.forename: Parthiv
authors.initials: P
authors.lastname: Shah
authors.forename: Gurjit
authors.initials: G
authors.lastname: Singh
authors.forename: Shalabh
authors.initials: S
authors.lastname: Chandra
authors.forename: Claudio D
authors.initials: CD
authors.lastname: Schuger
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable; D004553:Electric Conductivity; D004567:Electrodes, Implanted; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D006333:Heart Failure / Q000517:prevention & control*; D006801:Humans; D008297:Male; D017211:Treatment Failure