Electronic muscle stimulation (TENS) used in chiropractic therapy can cause electromagnetic interference leading to inappropriate ICD shocks, and should generally be avoided in patients with ICDs.
Clinicians should consider novel EMI sources in ICD patients with unexplained shocks; this case extends known triggers but leaves broader applicability open.
Implantable cardioverter defibrillators (ICDs) have been shown to reduce mortality in high-risk patients. Despite several advances in programming ICDs, inappropriate shocks persist and continue to be psychologically and physically disturbing. External electromagnetic interference from electrocautery, welding, acupunctures, low-output transcutaneous electric nerve stimulators, and electronic muscle stimulators may result in inappropriate ICD sensing and shock. We present a 63-year-old female who presented to the emergency department after an ICD shock while undergoing electronic muscle stimulation in chiropractic treatment, during which light electrical pulses were sent through skin electrodes. Our case highlights the importance of recognizing methods used by alternative medicine doctors, including electrical muscle stimulation that may cause electromagnetic interference and inappropriate ICD discharge and therefore, a higher overall mortality risk.
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Shenoy et al. (2017) studied this question.
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