“Once Shocked, Twice Shy”: A Case of Post-Traumatic Stress Disorder Following a Single Inappropriate ICD Shock

Implantable cardioverter-defibrillators (ICD) are effective for primary and secondary prevention of sudden cardiac death, as established via multiple clinical trials1,2. Despite these clinical benefits, the patient experience of living with an ICD can be challenging, often requiring emotional and behavioral adjustment. Psychological distress is common, with notable rates of anxiety (22.6%), depression (15.8%), and post-traumatic stress disorder (PTSD; 12.4%)3. Key challenges include lifestyle disruption and device-related concerns such as fear of shock recurrence, fear of physical activity, poor device acceptance, and body image concerns4–7.