Bullet Impact Into Automatic Implantable Cardioverter-Defibrillator Averts Serious Injury and Death

A 26-year-old man with hypertrophic obstructive cardiomyopathy and an automatic implantable cardioverter-defibrillator (AICD) sustained a gunshot injury to the left side of his chest wall, resulting in direct impact of the bullet into the AICD generator. The injury resulted in a dent in the outer case along with damage to the generator battery and device deactivation. There was no associated intrathoracic injury. The generator was successfully replaced, and the patient was discharged. This report describes a comprehensive device analysis and management of this extraordinary injury in a young patient with lifelong need for an AICD.