title: Lead thrombi associated with externalized cables on Riata ICD leads: a case series.
abstract: St. Jude Riata family ICD leads are subject to an FDA class I recall due to insulation failure, cable extrusions, and a high rate of electrical failures. We present multiple cases of large intravascular thrombus formation adherent to externalized conductor cables on Riata leads. Our observations highlight a previously unknown risk of large or calcified thrombus formation involving externalized conductors. We suggest that these leads should be screened for thrombi prior to potential lead extraction to determine the safest approach. Serial echocardiography may help detect progressive thrombus formation. The role of systemic anticoagulation for prevention or treatment of these thrombi remains unclear.
authors.affiliation: Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
authors.forename: Sandeep K
authors.initials: SK
authors.lastname: Goyal
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Ellis
authors.forename: Jeffery N
authors.initials: JN
authors.lastname: Rottman
authors.forename: S Patrick
authors.initials: SP
authors.lastname: Whalen
mesh_terms: D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004567:Electrodes, Implanted / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000175:diagnosis* / Q000209:etiology
keywords: Riata; implantable cardioverter defibrillator; lead extraction; lead recall; lead thrombi