Riata silicone defibrillation lead with normal electrical measures at routine ambulatory check: The role of high-voltage shock testing

Table 1 Potential role of high-voltage shock testing for the management of Riata™ leads with normal baseline electrical measures

At the time of generator replacement

All cases, with and without externalization, except if contraindications

Independently of generator replacement (case-by-case evaluation)

High risk patient: Recent/prior appropriate ICD shocks; secondary prevention; pacemaker dependency; young age

High risk lead: Externalization, especially if worsening over time; minimal change in electrical parameters not sufficient to define malfunction; 8Fr dual coil leads (?); 1570-1580-1590 families (?)

When to perform: Within 6-12 mo of an effective shock?

How often: Each 6-12 mo?

Contraindication or excessive risk with ventricular fibrillation induction

Commanded synchronized HV shock (preferably > 20 J)

ICD: Implantable cardioverter defibrillator; HV: High-voltage.