Inappropriate ICD shock due to hot tub-induced external electrical interference
Mohammad Shenasa1, Shahriar Heidary1, Hossein Shenasa1
1Heart & Rhythm Medical Group, San Jose, CA 95128, USA; O'Connor Hospital, San Jose, CA 95128, USA.
Background:
A 72-year-old white male with a history of rapid nonsustained ventricular tachycardia, hypertrophic cardiomyopathy, and intermittent Brugada-type ECG had a single-lead implantable cardioverter-defibrillator (ICD) implantation and received a sudden ICD shock while in the hot tub. To the best of our knowledge this is the first case report of hot tub jet-induced inappropriate ICD shock.
Methods:
ICD interrogation and analysis of intracardiac electrograms and event markers.
Results:
ICD interrogation revealed inappropriate ICD shocks due to electrical interference of hot tub engine; 60-cycle electrical artifact mimicking fast ventricular fibrillation erroneously detected by the device. The device then delivered a 34.8 joules shock while the patient was actually in sinus rhythm.
Conclusions:
Electrical interference due to external sources such as hot tub engines may occur and produce an inappropriate detection and ICD shock. Precaution and patient education is warranted.
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