• biventricular pacing;
  • ICD;
  • lead failure;
  • riata lead

Premature Failure of a Riata Defibrillator Lead. A 63-year-old woman with a St. Jude Medical Riata 1570 right ventricular lead complained of intermittent hiccups 2 months after implant. Interrogation revealed elevated pacing threshold and diaphragmatic stimulation. Pacing and shock lead impedances remained stable. No inappropriate sensing was noted. Fluoroscopic examination of the lead revealed a thin radio-opaque wire seen between the 2 defibrillator coils away from the main body of the lead. After extraction, a tear in the insulation of the lead was noted allowing the inner wire to protrude. This case illustrates a novel mechanism of insulation failure without inappropriate sensing or impedance change.(J Cardiovasc Electrophysiol, Vol. 22, pp. 1070-1072, September 2011)