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Early inappropriate shock in a subcutaneous cardiac defibrillator due to subcutaneous air
Ryo Nishinarita1, Jun Kishihara1, Gen Matsuura1
1Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan.
Abstract:
A 57-year-old man was admitted to our hospital due to syncopal attack. He was diagnosed with Brugada syndrome due to which a subcutaneous implantable cardiac defibrillator (S-ICD) was inserted using the standard technique. Two hours after the implantation, he experienced inappropriate shock while conscious. Device interrogation revealed a contentious baseline shift and frequent oversensing of low-amplitude signals, which was followed by a shock. Lateral chest X-ray revealed subcutaneous air surrounding the proximal electrode. Another inappropriate shock could be avoided by changing the sensing vector. The subcutaneous air was completely resolved 7 days after implantation.
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