Open AccessImplantable cardioverter‐defibrillator failure unmasked by a “lucky” shock
Author(s) -
Eng Lim K.,
Walters Tomos E.,
Gould Paul A.
Publication year - 2012
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2012.04.002
Subject(s) - medicine , ventricular fibrillation , defibrillation , implantable cardioverter defibrillator , cardiology , shock (circulatory) , casing , mechanical engineering , engineering
A young woman with placement of a dual‐chamber implantable cardioverter‐defibrillator (ICD) and a history of prior cardiac arrest due to congenital long QT syndrome presented with defibrillation caused by a ventricular fibrillation arrest. Routine device interrogation revealed significant lead dysfunction. During device revision, breaches were detected in the insulation of both leads within the pre‐pectoral pocket and an “arc mark” was observed on the ICD generator casing; these findings were consistent with a high‐voltage discharge through a short circuit between the denuded right ventricular lead and the casing. In this case, system failure was unmasked only by interrogation after appropriate device activation, which highlights the importance of thorough evaluation after all ICD activations.