{"id":34324,"date":"2013-01-28T08:00:41","date_gmt":"2013-01-28T13:00:41","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&#038;p=34324"},"modified":"2013-01-24T23:18:15","modified_gmt":"2013-01-25T04:18:15","slug":"getting-a-read-on-st-jude-leads-an-interview-with-robert-g-hauser","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/01\/28\/getting-a-read-on-st-jude-leads-an-interview-with-robert-g-hauser\/","title":{"rendered":"Getting a Read on St. Jude Leads: An Interview with Robert G. Hauser"},"content":{"rendered":"<p>In August 2012, Dr. Robert G. Hauser and colleagues from the Minneapolis Heart Institute published a paper <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/voices\/new-questions-about-latest-generation-icd-leads-from-st-jude\/\">analyzing failures<\/a> of St. Jude Durata and Riata ST Optim ICD leads.\u00a0Last week the FDA released a <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/news\/fda-releases-warning-letter-to-st-jude-about-icd-leads\/\">warning letter<\/a> previously sent to St. Jude \u00a0indicating serious violations found in a California plant manufacturing these leads and that the company&#8217;s response has not been adequate. CardioExchange&#8217;s Dr. John Ryan asked Dr. Hauser about the problems with these products.<\/p>\n<p><strong>Dr. Ryan:<\/strong> Do you feel vindicated having being among the first to highlight the issues with the Riata leads?<\/p>\n<p><strong>Dr. Hauser:<\/strong> Disturbed more than vindicated. Why does it take a major device recall for the FDA to uncover manufacturing deficiencies in a Class 3 product?<\/p>\n<p><strong>Dr. Ryan:<\/strong> What do you think is the path forward for oversight of ICD leads and similar devices?<\/p>\n<p><strong>Dr. Hauser:<\/strong> Creation of a transparent active post-market surveillance system for all implantables but certainly for lifesaving\/life supporting devices.<\/p>\n<p><strong>Dr. Ryan:<\/strong> What are your recommendations to your patients that have Riata and Durata leads?<\/p>\n<p><strong>Dr. Hauser:<\/strong> We are evaluating every patient who received a Riata lead and deciding if prophylactice replacement is appropriate. Of particular concern is short-circuiting, which can be fatal if it occurs during shock delivery for \u00a0Ventricular Fibrillation and \u00a0Ventricular Tachycardia; this is usually due to a short between a high voltage cable and a shocking coil, and it has been seen in Riata leads that appeared to be functioning normally based on standard testing. In regard to Durata, we no longer implant this lead. I believe Durata has the same design flaw as Riata but we need long-term data to prove this hypothesis one way or the other.<\/p>\n<p><strong>What are you doing for patients with these leads? Are there steps that you think need to be taken to make these devices safer?<\/strong><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The researcher and EP who first documented problems with St. Jude next generation leads reacts to the FDA&#8217;s recent letter to the company and explains what he is doing for patients who have received these devices.<\/p>\n","protected":false},"author":679,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13,1],"tags":[1265,196,681,975,1209],"class_list":["post-34324","post","type-post","status-publish","format-standard","hentry","category-electrophysiology","category-general","tag-durata","tag-fda","tag-icd-leads","tag-riata","tag-st-jude-medical"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34324","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/679"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=34324"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/34324\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=34324"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=34324"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=34324"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}