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Inefficacy of implantable cardioverter/defibrillator (ICD) shocks or inappropriate shocks in ICD patients may occur due to mechanical or technical failure of the device. In our unusual case of ICD defibrillation failure, faulty insertion and configuration of the defibrillation lead in the header port resulted in ineffective shock therapies and a non-determinable defibrillation threshold. In cases of successless defibrillations during or after ICD implantation, this problem should be considered.

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Non-determinable defibrillation threshold and inefficacy of implantable cardioverter/defibrillator shocks due to defective connections of the defibrillator lead terminals in the device header port