Pacing-dependency following implantable cardioverter-defibrillator shocks: a case report

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Implantable cardioverter-defibrillators (ICDs) prevent sudden cardiac death but can cause adverse events.
• Psychological harm and reduced quality of life are known ICD shock complications.
• Cardiac injury from transvenous ICD shocks is less recognized.

Observation:

• A case of atrioventricular block and pacing dependency occurred after multiple ICD shocks.
• This highlights a direct cardiac consequence of ICD therapy.

Findings:

• Repeated ICD shocks can induce atrioventricular block.
• This can lead to a dependence on ventricular pacing.

Implications:

• Clinicians must consider the risk of AV block and pacing dependency in patients receiving multiple ICD shocks.
• This is particularly relevant for patients with depleted pulse generators following extensive shock therapy.