Displaced AICD Lead Presenting as Hiccups: A Rare Complication

Area of Science:

• Cardiology
• Medical Devices

Background:

• Ventricular fibrillation poses a risk of sudden cardiac death.
• Automatic implantable cardioverter defibrillators (AICDs) are effective in terminating arrhythmias and preventing sudden cardiac death.
• This case involves a 69-year-old female with a history of paroxysmal atrial fibrillation who presented with hiccups.

Observation:

• The patient had a prior admission for monomorphic ventricular tachycardia.
• Cardiac work-up revealed no significant coronary artery disease or cardiomyopathy.
• An AICD was successfully implanted.

Findings:

• Twelve weeks post-implantation, the patient developed sudden hiccups while lifting furniture.
• Chest X-ray revealed AICD lead displacement from the right ventricular apex to the superior vena cava.
• Lead repositioning led to complete resolution of hiccups.

Implications:

• Hiccups following AICD implantation may indicate lead displacement.
• The suspected etiology is phrenic nerve irritation due to lead proximity to the superior vena cava.
• Healthcare providers should consider AICD lead displacement in patients presenting with hiccups post-implantation.