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We report the case of an 18-year-old hypertrophic cardiomyopathy female with a subcutaneous implantable cardioverter-defibrillator (S-ICD) for primary prevention who presented with monomorphic ventricular tachycardia and five ineffective 80-J shocks. We have examined the patient case notes, imaging and electrophysiology study data, and traces obtained from S-ICD device interrogation. This is a rare example of device failure in an otherwise safe and effective system as illustrated by EFFORTLESS and IDE data.

Ineffective Shock Therapy in a Subcutaneous Implantable Cardioverter-Defibrillator Patient with Hypertrophic Cardiomyopathy