Introduction: Abbott Riata® (AR) leads are prone to conductor externalization but have similar annual failure rates compared to industry benchmarks. A recent multi-center study showed that lead extraction (LE), lead abandonment (LA), and generator change only (GC) have similar long-term outcomes for the recalled Sprint Fidelis® and AR leads when analyzed collectively. However, a study evaluating only AR lead management with these strategies has not been done. We sought to evaluate if outcomes are worse with more invasive strategies (LE and LA) vs. GC when managing AR leads. Hypothesis: To compare outcomes after LE, LA, and GC strategies for AR leads. Methods: This is a 5-center, retrospective study evaluating LE, LA and GC strategies for AR. The incidence of peri-procedural complications, 60-day extended or repeat hospitalization [ERHOSP], death within 60 days, subsequent lead malfunctions, and long-term mortality were compared amongst LE, LA, and GC strategies. Results: 165 patients (65± 13 years, 68% male) were followed for a mean 33 ± 30 months following intervention. Outcomes are listed on Table 1. Total AR lead dwell time follow-up was 16633 months. A total of 3 AR lead malfunctions were noted during long-term follow-up. Inappropriate shocks were similar between LE 7.7% (1/13), LA 6.3% (1/16) and GC 11.0% (15/136); P=0.74. Conclusions: More invasive lead management (LE and LA) resulted in increased death within 60 days and ERHOSP after adjusting for long-term lead malfunction with GC. Long-term mortality was also more favorable in the GC group. AR leads should only be extracted or revised if they demonstrate evidence of lead malfunction when the device reaches end of life.