Impact of acquired anatomical distortion on implantable cardiac defibrillator efficacy: Lessons from a postpneumonectomy patient

The implantable cardioverter defibrillator (ICD) has been a mainstay of therapy for primary and secondary prevention of sudden cardiac death caused by malignant ventricular arrhythmias for over thirty years [1]. Prior to the SIMPLE (Shockless IMPLant Evaluation) and NORDIC (NO Regular Defibrillation Testing in Cardioverter Defibrillator Implantation) trials, routine defibrillation threshold (DFT) testing at implant was considered standard practice to confirm an ICD's ability to terminate dangerous ventricular arrhythmias [2,3].