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Related Concept Videos

Disturbances in Heart Rhythm01:28

Disturbances in Heart Rhythm

895
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
895

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Related Experiment Video

Updated: Jun 3, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
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Bullet Impact Into Automatic Implantable Cardioverter-Defibrillator Averts Serious Injury and Death.

Jonathan A Reimer1, Khaled Abdelhady1,2, Raed Sawaqed2

  • 1Department of Surgery, Mount Sinai Hospital, Chicago, Illinois.

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Summary

A gunshot to the chest damaged an automatic implantable cardioverter-defibrillator (AICD) in a young man with hypertrophic obstructive cardiomyopathy. Device replacement was successful, highlighting rare AICD injury management.

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Area of Science:

  • Cardiology
  • Trauma Surgery
  • Biomedical Engineering

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) necessitates automatic implantable cardioverter-defibrillator (AICD) implantation for sudden cardiac death prevention.
  • Traumatic injuries to implanted cardiac devices are rare but can have severe consequences.
  • This case involves a young patient with HOCM and an AICD who sustained a penetrating chest trauma.

Observation:

  • A 26-year-old male with HOCM and an AICD experienced a gunshot wound directly impacting the AICD generator.
  • The impact caused external casing damage, internal battery compromise, and device deactivation.
  • No intrathoracic injuries were identified, indicating a localized impact on the device.

Findings:

  • The AICD generator sustained significant damage, including a dented casing and battery failure, leading to device deactivation.
  • Prompt surgical intervention involved successful replacement of the AICD generator.
  • Comprehensive device analysis was performed to understand the failure mechanism.

Implications:

  • This case underscores the vulnerability of AICD devices to direct ballistic trauma.
  • It highlights the importance of specialized management protocols for traumatic AICD injuries.
  • Successful device replacement ensures continued protection for patients with lifelong pacing and defibrillation needs.