Electromagnetic Interference from Electronic Article Surveillance System in a patient with a Biventricular ICD and a Left Ventricular Assist Device

biomedical engineering, defibrillation -ICD Case PresentationA 62-year-old man with a history of familial nonischemic dilated cardiomyopathy, sick sinus syndrome, atrial fibrillation, and complete heart block was implanted with a St. Jude Atlas-II HF biventricular implantable cardioverter defibrillator (BiV ICD; St. Jude Medical, St. Paul, MN, USA), with a Guidant 0158 integrated bipolar ventricular lead (Guidant Corp., St. Paul, MN, USA) and a Medtronic 5554 bipolar atrial lead (Medtronic Inc., Minneapolis, MN, USA) in 2006.He had a HeartMate II left ventricular assist device (LVAD; Thoratec Inc., Pleasanton, CA, USA) implantation in March 2009, as bridge to cardiac transplantation for end-stage heart failure.His BiV ICD was programed as follows: DDDR mode with a base rate of 85 beats/min and a maximum track rate of 120 beats per minute (bpm) with paced and sensed atrioventricular delays being 190 ms and 150 ms, respectively.His ventricular noise reversion mode was VOO and atrial tachycardia detection rate was 180 bpm.The "tachy" parameters of the device were programed as follows: ventricular tachycardia (VT)-1 = 440 ms, VT-2 = 315 ms, ventricular fibrillation (VF) = 270 ms, and all zones had to fulfill 12 intervals.He went to a bicycle store, accompanied by his daughter.After they purchased the bicycle and were about to leave the store, he was lingering at the antitheft detection system of the store for approximately 2 minutes.He then experienced an ICD shock.Of note, none of his prior interrogations revealed any problems suggestive of lead fracture.