title: Long-Term Performance of the Riata/ST Implantable Cardioverter-Defibrillator Lead.
abstract: Riata and Riata ST implantable cardioverter-defibrillator leads are prone to structural and electrical failure (EF). Our objective was to evaluate Riata/ST lead performance over a long-term follow-up. Of 184 patients having undergone Riata/ST and Riata ST Optim lead implantation from September 2003 to June 2008, 154 patients were evaluated for EF and radiographic conductor externalization (CE). Survival analysis for EF was performed for Riata/ST leads, both for failure-free lead survival and cumulative hazard. Subanalysis on 7Fr leads was performed to evaluate EF and CE rates both for different Riata ST lead management (monitoring vs proactive) and between Riata ST and Riata ST Optim leads. During a mean follow-up of 7 years, Riata/ST lead EF rate was 13% overall. Similar failure-free survival rate was noted for 7Fr as for 8Fr leads (log-rank, p = 0.63). Of all failed leads, 64% failed only after 5 years of follow-up. Compared with the absolute failure rate of 1.84% per device year, cumulative hazard analysis for leads surviving past 5 years revealed an estimated failure rate of 7% per year. No clinical or procedural predictors for EF were found. The subanalysis on 7Fr leads showed an excellent outcome both for a proactive lead management approach as for Optim leads. In conclusion, long-term survival of the Riata/ST lead is impaired with an accelerating EF risk over time. An initial exponential trend was followed by a linear lead failure pattern for leads surviving past 5 years, corresponding to an estimated 7% annual EF rate. These findings may have repercussions on the lead management strategy in patients currently surviving with a Riata/ST lead to prevent significant clinical events like inappropriate shocks or failed device interventions.
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: strokerwin@gmail.com.
authors.forename: Erwin
authors.initials: E
authors.lastname: Ströker
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Carlo
authors.initials: C
authors.lastname: de Asmundis
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Vanduynhoven
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Katrien
authors.initials: K
authors.lastname: De Vadder
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Philip
authors.initials: P
authors.lastname: De Vusser
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Mullens
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Gian-Battista
authors.initials: GB
authors.lastname: Chierchia
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brugada
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Jens
authors.initials: J
authors.lastname: Czapla
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Mark
authors.initials: M
authors.lastname: La Meir
authors.affiliation: Heart Rhythm Management Centre, Universitair Ziekenhuis Brussel-Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Francis
authors.initials: F
authors.lastname: Wellens
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Hugo
authors.initials: H
authors.lastname: Van Herendael
authors.affiliation: Department of Cardiology, Ziekenhuis Oost-Limburg, Genk, Belgium.
authors.forename: Maximo
authors.initials: M
authors.lastname: Rivero-Ayerza
mesh_terms: D009202:Cardiomyopathies / Q000628:therapy*; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors