Conductor externalization of the Riata internal cardioverter defibrillator lead: tip of the iceberg? Report of three cases and review of literature.

Aims: Recently, concerns about St Jude's Riata lead family have come to light. We present three cases of patients with Riata internal cardioverter defibrillator (ICD) leads with externalized conductors.

Methods And Results: All patients had the same insulation defect, with externalized conductors, but differed in presentation and symptoms. These cases, which form 3 of 179 (1.68%) of our total Riata lead population, presented four or more years after implantation. This may be an indication that the problem with the Riata lead may well be greater than reported in the recent St Jude Medical device advisory letter.

Conclusion: The management of the Riata lead problem is discussed as, up until now, management of patients with an implanted Riata lead has been based on detecting electric abnormalities on regular ICD interrogation only.