Dual tachycardia induced by electrocution terminated by an implantable cardioverter-defibrillator

Key Teaching Points•Electrical injury and electrocution are relatively common in the United States. The various effects of electrical injury include skin burns, internal organ damage, direct myocardial damage, and cardiac arrhythmias.•High-voltage shocks, defined as shocks from sources >1000 V, may result in myocardial necrosis, cardiac standstill, and sudden cardiac death. Low-voltage shocks, defined as shocks from sources <1000 V, particularly with alternating current seen in household electrical systems, may result in cardiac stimulation resulting in atrial fibrillation or ventricular fibrillation.•The presence of a dual-chamber implantable cardioverter-defibrillator offers unique insights into the initiation of cardiac arrhythmias by electrical injury and electrocution. •Electrical injury and electrocution are relatively common in the United States. The various effects of electrical injury include skin burns, internal organ damage, direct myocardial damage, and cardiac arrhythmias.•High-voltage shocks, defined as shocks from sources >1000 V, may result in myocardial necrosis, cardiac standstill, and sudden cardiac death. Low-voltage shocks, defined as shocks from sources <1000 V, particularly with alternating current seen in household electrical systems, may result in cardiac stimulation resulting in atrial fibrillation or ventricular fibrillation.•The presence of a dual-chamber implantable cardioverter-defibrillator offers unique insights into the initiation of cardiac arrhythmias by electrical injury and electrocution.