Public Electric Baths in Japan: A Risk of Inappropriate Implantable Cardioverter-Defibrillator Shock

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Device Safety

Background:

• Subcutaneous implantable cardioverter-defibrillators (S-ICDs) are advanced devices for preventing sudden cardiac death.
• Environmental electromagnetic interference can potentially affect medical device function.
• Public bathing facilities present unique environmental conditions.

Purpose of the Study:

• To report the first case of inappropriate S-ICD shock triggered by an electric bath.
• To highlight potential environmental risks associated with S-ICD use.
• To inform clinicians and patients about rare S-ICD malfunction scenarios.

Main Methods:

• Case report detailing patient presentation and S-ICD event.
• Analysis of the S-ICD device logs and interrogation data.
• Review of the environmental factors present during the event, specifically the public electric bath.

Main Results:

• The S-ICD delivered an inappropriate shock to the patient.
• Device interrogation confirmed the shock was triggered by external electrical interference, consistent with the electric bath environment.
• This represents the first documented instance of such an event in Japan.

Conclusions:

• Public electric baths can pose a risk of inappropriate shocks for S-ICD patients.
• Awareness of environmental triggers is crucial for S-ICD management.
• Further investigation into electromagnetic compatibility in diverse environments is warranted.