Why the study?
Complications with subcutaneous implantable cardioverter-defibrillators are rarer than with transvenous ICDs, but they do still occur.
Case Report (n=1)
S-ICD lead dislodgement is a rare complication that can present atypically as referred shoulder pain due to phrenic nerve irritation, necessitating high clinical suspicion and appropriate imaging.
Shoulder pain post-S-ICD may indicate rare lead migration; this case extends reported complications but leaves open incidence and prevention data.
Implantable cardioverter-defibrillators (ICDs) have demonstrated efficacy in the prevention of sudden cardiac death secondary to cardiac arrhythmias in eligible patients. Complications with the subcutaneous ICD (S-ICD) are rarer than with the transvenous ICD but do still exist. Our patient presented four weeks after the insertion of S-ICD with complaints of left shoulder pain radiating to the chest wall and swelling over the S-ICD site. He was initially treated for rotator cuff injury and subacromial impingement syndrome but upon obtaining chest radiography was found to have a lead displacement traversing the splenic flexure of the colon. The patient was managed by a treatment team involving cardiology, surgery, and infectious disease and underwent S-ICD removal, exploratory laparotomy with splenic flexure mobilization, and completion of a four-week antibiotic course ultimately leading to reimplantation of S-ICD.
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Chirumamilla et al. (2023) conducted a case report in S-ICD lead dislodgement (n=1). Subcutaneous Implantable Cardioverter-Defibrillator (S-ICD) was evaluated.
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