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Related Experiment Videos

ICD hardware failure associated with multiple internal shocks.

L A Nair1, E L Ostrow, B Beck

  • 1Sulzer Intermedics Inc., Angleton, Texas, USA. lnair@phs.org

Pacing and Clinical Electrophysiology : PACE
|June 2, 2000
PubMed
Summary
This summary is machine-generated.

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Sudden delivery of 37 implantable cardioverter-defibrillator (ICD) shocks due to T wave oversensing caused device malfunction and circuit damage. This highlights risks associated with excessive electrical stress on ICDs.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Device Technology

Background:

  • Implantable cardioverter-defibrillators (ICDs) are crucial for managing life-threatening arrhythmias.
  • Atrial flutter can sometimes lead to inappropriate shocks from ICDs due to sensing abnormalities.
  • T wave oversensing is a known, albeit infrequent, cause of inappropriate ICD discharge.

Observation:

  • A patient experienced 37 ICD shocks within 20 minutes.
  • These shocks were triggered by T wave oversensing during an episode of atrial flutter.
  • The ICD generator entered backup mode, disabling key functions like automatic capacitor reformation and therapy delivery.

Findings:

  • Post-explant analysis revealed significant damage to the high-voltage output circuitry.

Related Experiment Videos

  • The damage was consistent with excessive electrical stress from the rapid, multiple shocks.
  • This case demonstrates a potential failure mode of ICDs under extreme electrical load.

    • Implications:

    • Frequent, inappropriate ICD shocks can lead to device malfunction and physical damage.
    • Excessive electrical stress may increase the vulnerability of ICD circuitry.
    • Clinical vigilance is necessary to identify and manage rare but serious adverse events related to ICD therapy delivery.