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Premature Failure of a Riata Defibrillator Lead Without Impedance Change or Inappropriate Sensing: A Case Report and Review of the Literature

Authors


  • R.D. Berger receives fellowship support from St. Jude Medical and is a consultant to Boston Scientific. A. Cheng has received honorarium from Biotronik, Boston Scientific, Medtronic, and St. Jude Medical. Other authors: No disclosures.

Alan Cheng, M.D., 600 N. Wolfe Street, Carnegie 568, Baltimore, MD 21287. Fax: +410-502-0231; E-mail: alcheng@jhmi.edu

Abstract

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)

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