Key result
Riata ICD leads in pediatric and congenital heart disease patients had a 43% electrical failure rate and a 16% conductor coil externalization rate over a median follow-up of 8.7 years.
Why the study?
ICD lead failures occur at higher rates in pediatric and CHD patients, prompting investigation into the rate and timing of Riata lead failure in this population.
What is the rate and timing of Riata lead failure in pediatric and congenital heart disease patients?
Cohort (n=58)
Yes
What is the rate and timing of Riata lead failure in pediatric and congenital heart disease patients?
Riata ICD leads have a high rate of electrical failure (43%) in pediatric and congenital heart disease patients, highlighting the need for careful monitoring and consideration of elective replacement.
Answers are grounded in this paper and cite their sources.
Supports closer monitoring of Riata leads in pediatric congenital patients; leaves open optimal management strategies.
BACKGROUND: Implantable cardioverter defibrillator (ICD) lead failures occur at higher rates in pediatric and congenital heart disease (CHD) patients. OBJECTIVE: To determine the rate and timing of Riata lead failure in pediatric and CHD patients. METHODS: This was a retrospective, multicenter cohort study of pediatric patients and adults with CHD with implantation of a Riata or Riata ST lead between 2002 and 2009. The prevalence and timing of electrical failure and conductor coil externalization (CCE) were determined. RESULTS: Fifty-eight patients and 63 leads from seven centers were included. Median (interquartile range [IQR]) age at implant was 14.4 (11.5-18.7) years and median follow-up was 8.7 (7.3-11.1) years. The underlying diagnosis was a primary arrhythmia disorder in 45%, cardiomyopathy in 31%, and CHD in 28% of patients. Electrical failure occurred in 43% and CCE in 16% of leads at median lead ages of 4.7 (3.4-7.5) and 4.3 (3.9-7.0) years, respectively. Median lead survival free from electrical failure or CCE was 7.9 (95% confidence interval, 5.8-10.0) years. Forty-one percent of leads were functional at the end of the follow-up period, and 33% were extracted with a complication rate of 5%. CONCLUSIONS: The rate of Riata lead electrical failure was high in children and patients with CHD, while the rate of CCE was comparable with published data. Counseling on lead management should factor in the high rate of electrical failure with considerations for elective replacement.
No takes yet. Share an insight, caveat, or question.
Escudero et al. (2018) conducted a cohort in Pediatric and congenital heart disease (n=58). Riata or Riata ST lead was evaluated on Electrical failure and conductor coil externalization (CCE). Riata ICD leads in pediatric and congenital heart disease patients had a 43% electrical failure rate and a 16% conductor coil externalization rate over a median follow-up of 8.7 years.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: