Phantom Shocks Associated With a Wearable Cardioverter Defibrillator

Area of Science:

• Cardiology
• Medical Devices
• Psychosomatic Medicine

Background:

• Wearable cardioverter defibrillators (WCDs) offer an alternative to implantable cardioverter defibrillators (ICDs) for managing life-threatening arrhythmias like ventricular tachycardia (VT) and ventricular fibrillation (VF).
• While ICDs are effective in preventing sudden cardiac death (SCD), patients may experience psychological distress, including fear of shock and reduced quality of life.
• Phantom shock (PS) is a reported phenomenon in ICD patients, characterized by the perception of a shock without device-recorded evidence.

Observation:

• This report details the first known case of phantom shock (PS) associated with a wearable cardioverter defibrillator (WCD).
• The case underscores the importance of recognizing PS as a distinct entity from actual device-delivered shocks.
• Psychosocial factors are explored in relation to the occurrence of PS in patients using cardiac devices.

Findings:

• The study reviews the literature on PS prevalence, contributing factors, and interventions to mitigate its occurrence.
• Phantom shock requires careful differentiation from real shocks to avoid unnecessary device reprogramming or discontinuation.
• Management strategies should address both the device-related phenomenon and associated psychiatric or psychosocial factors.

Implications:

• Recognizing and differentiating WCD-related phantom shock is crucial for accurate clinical assessment and treatment.
• Addressing psychosocial factors and potential psychiatric comorbidities is essential for comprehensive patient care.
• This case and review emphasize the need for increased awareness of phantom shock in patients using external cardiac defibrillation devices.