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Related Experiment Video

Updated: Sep 16, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock

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Published on: June 12, 2021

Management of Gunshot Injury Involving Cardiac Implantable Electronic Device.

Saad A Ali¹, Nektarios Vasilottos¹, Mithilesh K Das¹

¹Division of Cardiovascular Medicine, Indiana University, Indianapolis, Indiana, USA.

JACC. Case Reports

|July 4, 2025

Summary

Managing firearm injuries with cardiac implantable electronic devices (CIEDs) requires careful consideration. This case highlights challenges in extracting a damaged implantable cardioverter-defibrillator (ICD) with a retained bullet, emphasizing a multidisciplinary approach for patient care.

Keywords:

cardiac implantable electronic device gunshot implantable cardioverter defibrillator

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Published on: February 28, 2012

Area of Science:

Cardiology
Trauma Surgery
Medical Device Engineering

Background:

Firearm injuries pose unique management challenges when they involve cardiac implantable electronic devices (CIEDs).
Implantable cardioverter-defibrillators (ICDs) are susceptible to damage from ballistic trauma.

Observation:

A 69-year-old male sustained a self-inflicted gunshot wound to the chest, directly impacting his ICD.
The damaged ICD was successfully extracted, revealing a bullet lodged within its circuit board.
A new ICD system was implanted on the opposite side after the initial device removal.

Findings:

Ballistic trauma to an ICD necessitates complex surgical intervention and device management.
Retained projectiles within CIEDs present significant procedural and technical difficulties.
Successful management involves device extraction, management of associated injuries, and reimplantation.

Implications:

This case highlights the critical need for a multidisciplinary team approach in managing firearm-related CIED injuries.
Key considerations include pacemaker dependency, infection control, potential battery leakage, and surgical complexities.
Optimal patient outcomes depend on careful planning and coordinated care involving cardiology, surgery, and device specialists.