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Exploding Implantable Cardioverter Defibrillator
Author(s) -
SWEENEY MICHAEL O.
Publication year - 2001
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1046/j.1540-8167.2001.01422.x
Subject(s) - medicine , implantable cardioverter defibrillator , defibrillation , ventricular fibrillation , high impedance , electromagnetic coil , voltage , defibrillation threshold , high voltage , shock (circulatory) , cardiology , electrical engineering , optoelectronics , materials science , engineering
Exploding Implantable Cardioverter Defibrillator. A 79‐year‐old man with a pectoral implantable cardioverter defibrillator (ICD) system underwent periodic defibrillation threshold testing 18 months after implant. Attempted delivery of a 15‐J shock caused a light flash above the pocket and a loud “pop.” High‐voltage lead impedance was < 20 Ω. Pocket exploration revealed insulation abrasion of the high‐voltage portion of the single‐coil right ventricular lead. The outer shield of the active can pulse was perforated and scorched due to arcing. Device analysis confirmed a shorted transistor in the high‐voltage output circuit. Unsuspected physical contact between high‐voltage electrodes of opposite polarity within the pocket can cause catastrophic ICD system failure.