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    Research Letter
    December 20, 2019

    Long-term Outcome of Implantable Cardioverter/Defibrillator Lead Failure

    Author Affiliations
    • 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland
    • 2Landspitali–The National University Hospital of Iceland, Reykjavik, Iceland
    JAMA Intern Med. 2020;180(2):322-324. doi:10.1001/jamainternmed.2019.4717

    Implantable cardioverter/defibrillators (ICDs) are established for treatment and prevention of sudden death from ventricular arrhythmias.1 An ICD system consists of a generator and a lead. The design of the ICD leads differs between manufacturers, some of which have had higher lead failure rates than others.2

    The Riata defibrillator leads, manufactured by St Jude Medical Inc, were introduced in 2002. They had a novel silicone insulation design that was found to be prone to a specific insulation abrasion, characterized by externalization of the conductor (EC). These leads were designated to a class I recall by the US Food and Drug Administration in late 2011 owing to significant rates of lead failure and an insulation defect, posing significant management challenges.