Key result
Rapid delivery of 37 ICD shocks from T wave oversensing damages high voltage output circuitry.
Case Report (n=1)
Excessive electrical stress from multiple rapid internal ICD shocks can lead to severe hardware failure and loss of therapy delivery.
Multiple rapid ICD shocks may damage circuitry and disable therapy; leaves open incidence and prevention strategies.
The delivery of 37 shocks by an ICD within 20 minutes, in response to T wave oversensing during atrial flutter, resulted in several manifestations of undesirable device behavior. The generator reverted to backup mode, and disabled automatic capacitor reformation, therapy delivery, and automatic gain control. Postexplant analysis of the device revealed damage to the high voltage output section of the circuitry consistent with excessive electrical stress. In rare circumstances, multiple internal discharges can result in serious clinical anomalies in ICD behavior, and possibly in an increase in susceptibility to circuitry damage.
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Nair et al. (2000) conducted a case report in ICD hardware failure (n=1). Multiple internal shocks was evaluated on Device behavior and circuitry damage. The delivery of 37 shocks by an ICD within 20 minutes due to T wave oversensing resulted in backup mode reversion and damage to the high voltage output circuitry.
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