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  • Title: Premature failure of a Riata defibrillator lead without impedance change or inappropriate sensing: a case report and review of the literature.
    Author: Krebsbach A, Alhumaid F, Henrikson CA, Calkins H, Berger RD, Cheng A.
    Journal: J Cardiovasc Electrophysiol; 2011 Sep; 22(9):1070-2. PubMed ID: 21385268.
    Abstract:
    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.
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