Failure of a novel silicone-polyurethane copolymer (Optim™) to prevent implantable cardioverter-defibrillator lead insulation abrasions.
OBJECTIVE
The purpose of this study was to determine if Optim™, a unique copolymer of silicone and polyurethane, protects Riata ST Optim and Durata implantable cardioverter-defibrillator (ICD) leads (SJM, St Jude Medical Inc., Sylmar, CA, USA) from abrasions that cause lead failure.


RESULTS
We searched the US Food and Drug Administration's (FDA's) Manufacturers and User Device Experience (MAUDE) database on 13 April 2012 using the simple search terms 'Riata ST Optim™ abrasion analysis' and 'Durata abrasion analysis'. Lead implant time was estimated by subtracting 3 months from the reported lead age. The MAUDE search returned 15 reports for Riata ST Optim™ and 37 reports for Durata leads, which were submitted by SJM based on its analyses of returned leads for clinical events that occurred between December 2007 and January 2012. Riata ST Optim™ leads had been implanted 29.1 ± 11.7 months. Eight of 15 leads had can abrasions and three abrasions were caused by friction with another device, most likely another lead. Four of these abrasions resulted in high-voltage failures and one death. One failure was caused by an internal insulation defect. Durata leads had been implanted 22.2 ± 10.6 months. Twelve Durata leads had can abrasions, and six leads had abrasions caused by friction with another device. Of these 18 can and other device abrasions, 13 (72%) had electrical abnormalities. Low impedances identified three internal insulation abrasions.


CONCLUSIONS
Riata ST Optim™ and Durata ICD leads have failed due to insulation abrasions. Optim™ did not prevent these abrasions, which developed ≤ 4 years after implant. Studies are needed to determine the incidence of these failures and their clinical implications.
Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 500, Minneapolis, MN 55407, USA. rhauser747@aol.com
Robert G
RG
Hauser
Raed H
RH
Abdelhadi
Deepa M
DM
McGriff
Linda
L
Kallinen Retel
D001145:Arrhythmias, Cardiac / Q000628:therapy*; D016208:Databases, Factual; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D017097:Electric Impedance; D004567:Electrodes, Implanted / Q000009:adverse effects*; D019544:Equipment Failure Analysis; D006801:Humans; D011092:Polyethylene Glycols / Q000009:adverse effects*; D012828:Silicones / Q000009:adverse effects*; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration
D012828:Silicones; C095420:silicone polyethylene glycol copolymer; D011092:Polyethylene Glycols