A closed-loop spinal cord stimulation system in a patient with an implantable cardioverter defibrillator

Spinal cord stimulation (SCS) devices and implantable cardioverter defibrillators (ICDs) are well-established therapies for chronic pain management and mortality prevention in cardiovascular pathologies, respectively. As both devices rely on electrical current, there are concerns regarding potential interference between them that could lead to severe consequences.

In this case report, we describe the case of a 50-year-old woman who had been implanted with an ICD for 5 years due to ischemic cardiopathy and class III heart failure symptoms, and who was referred to the Pain Unit after 4 years of persistent pain on the soles of her feet, which had not responded to opioids nor to percutaneous procedures. Thus, after being deemed suitable by anesthesiologists and obtaining psychological approval, she underwent implantation of an SCS closed-loop system.

Three months after the procedure, she reported an 80% relief of her pain. Both devices effectively functioned at all times, and no interference was observed.

Pain management using a closed-loop SCS in a patient with an ICD can be safely performed without interference between the devices.