title: Prevalence and presentation of externalized conductors and electrical abnormalities in Riata defibrillator leads after fluoroscopic screening: report from the Netherlands Heart Rhythm Association Device Advisory Committee.
abstract: BACKGROUND
  The Riata family of implantable cardioverter-defibrillator (ICD) leads is prone to a specific insulation abrasion characterized by externalization of conductor cables. The objective of this study was to determine the prevalence of externalized conductors and electrical abnormalities in Riata ICD leads by fluoroscopic screening and standard ICD interrogation.
  
  
  RESULTS
  All ICD implantation centers were contacted by the Netherlands Heart Rhythm Association Device Advisory Committee to identify all patients with an active Riata ICD lead and to perform fluoroscopic screening of the lead. In addition, the electrical integrity of the lead was assessed. As of March 1, 2012, data for 1029 active Riata leads were available; 47% of these were 8-F Riata and 53% were 7-F Riata ST. Externalized conductors were observed in 147 leads (14.3%). Proportion of externalized conductors was higher in 8-F Riata compared with 7-F Riata ST (21.4% vs 8.0%; P<0.001). Median time from implantation to detection of externalized conductors was 65.3 months. The estimated rates of externalized conductors were 6.9% and 36.6% at 5 and 8 years after implantation, respectively. Of the 147 leads with externalized conductors, 10.9% had abnormal electrical parameters vs 3.5% in nonexternalized leads (P<0.001).
  
  
  CONCLUSIONS
  The prevalence of externalized conductors in Riata leads is significantly high (14.3%) using fluoroscopic screening. The majority of externalized conductors are not detectable with standard ICD interrogation. Screening with fluoroscopy is reasonable.
authors.affiliation: Department of Cardiology, Erasmus MC, 3000 CA Rotterdam, the Netherlands. d.theuns@erasmusmc.nl
authors.forename: Dominic A M J
authors.initials: DA
authors.lastname: Theuns
authors.forename: Arif
authors.initials: A
authors.lastname: Elvan
authors.forename: Willem
authors.initials: W
authors.lastname: de Voogt
authors.forename: Carel C
authors.initials: CC
authors.lastname: de Cock
authors.forename: Lieselot
authors.initials: L
authors.lastname: van Erven
authors.forename: Mathias
authors.initials: M
authors.lastname: Meine
mesh_terms: D026683:Advisory Committees; D001145:Arrhythmias, Cardiac / Q000628:therapy*; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure / Q000706:statistics & numerical data*; D004869:Equipment Safety / Q000379:methods; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D009426:Netherlands; D015995:Prevalence; D012189:Retrospective Studies