Integrity failure in Riata and Riata ST defibrillator leads: An ongoing problem

Riata and Riata ST silicone defibrillation leads are prone to externalization of con- ductors due to inside-out abrasion in the high-voltage system, causing structural damage which may be accompanied by electrical failure. These situations are easily detected by fluoroscopy or radiology and by inspection of intracardiac electrograms and/or measurement of impedance. However, older pulse generators do not automatically perform all the measurements needed to assess the integrity of the high-voltage electrical system, nor do they have patient notifier alerts in case of dysfunction. The authors describe the case of a patient in whom structural damage was detected on fluo- roscopy during pulse generator replacement. They discuss the best strategy in these patients, considering current knowledge of this dysfunction. © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L. All rights reserved.