Increased incidence of subacute lead perforation noted with one implantable cardioverter-defibrillator

Stephan B. Danik, Moussa Mansour, Jagmeet Singh, Vivek Y. Reddy, Patrick T. Ellinor, David Milan, E. Kevin Heist, Andre d'Avila, Jeremy N. Ruskin, Theofanie Mela

Research output: Contribution to journalArticlepeer-review

96 Scopus citations


Background: The rapid evolution of implantable cardioverter-defibrillator (ICD) leads has resulted in thinner active fixation leads. While these advances have made the leads more versatile, new configurations may be associated with unforeseen complications. Objective: The purpose of this study was to determine the incidence of perforation and dislodgement of defibrillator leads in a single center in the year 2005. Methods: All patients who underwent percutaneous ICD implantation at the Massachusetts General Hospital using an endocardial right ventricular lead were included in this study. The specific leads analyzed were the Riata (1580/1581 and 1590/1591, St. Jude Medical, St Paul, Minnesota, USA;) and Sprint Fidelis (6949-65, Medtronic, Minneapolis, Minnesota, USA.). Information was collected retrospectively. Results: A total of 130 Riata leads and 111 Sprint Fidelis leads were implanted at the Massachusetts General Hospital during this time period. A total of five lead perforations occurred in patients implanted with the Riata lead as compared with none with the Sprint Fidelis lead (3.8% vs. 0%, respectively; P <.05). Two of the five patients with perforation required pericardiocentesis for tamponade. Clinical symptoms of perforation developed 1-10 days after implant. Moreover, there were five additional lead revisions in the Riata group, which were likely due to dislodgement and/or microperforation, as compared with none in the Sprint Fidelis group (7.7% vs. 0%, respectively; P <.005). Conclusions: In 2005, at one institution, there were significantly more cardiac perforations and lead revisions with the Riata lead as compared with the Sprint Fidelis right ventricular defibrillator lead. Further data are required to determine whether certain lead characteristics are responsible for this observation.

Original languageEnglish
Pages (from-to)439-442
Number of pages4
JournalHeart Rhythm
Issue number4
StatePublished - Apr 2007
Externally publishedYes


  • Cardiac perforation
  • Defibrillator
  • Lead dislodgement
  • Lead revision
  • Right ventricular lead


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