Key result
SICD in a pacemaker-dependent patient linked to device-device interaction causing VF undersensing and shock failure.
Why the study?
Complex device-device interactions can occur in patients who are pacemaker dependent and undergo placement of a subcutaneous implantable cardiac defibrillator (SICD).
Does SICD placement in a pacemaker-dependent patient lead to adverse device-device interactions?
Case Report (n=1)
Does SICD placement in a pacemaker-dependent patient lead to adverse device-device interactions?
Complex and potentially life-threatening device-device interactions can occur in pacemaker-dependent patients undergoing SICD placement, highlighting the need for careful testing and consideration of transvenous ICDs.
Requires careful pre-implant testing in pacemaker-dependent SICD recipients; case report leaves open optimal device strategy.
A 26-year-old patient with prior surgery for Ebstein's anomaly and a pacemaker (placed for post-surgical heart block and poor underlying rhythm) underwent SICD was placement. During defibrillation testing, device-device interaction led to undersensing of ventricular fibrillation with failure to shock. Increasing the pacemaker sensitivity resolved the problem but post shock pacing was unable to capture the heart after both shocks. The patient underwent removal of both the pacemaker and the SICD and placement of a transvenous ICD. Complex device-device interactions can occur in patients who are pacemaker dependent and undergo placement of a SICD.
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Abbott et al. (2021) conducted a case report in Ebstein's anomaly, pacemaker dependent, undergoing SICD placement (n=1). Subcutaneous implantable cardiac defibrillator (SICD) placement was evaluated on Device-device interaction during defibrillation testing. Subcutaneous implantable cardiac defibrillator (SICD) placement in a pacemaker-dependent patient led to adverse device-device interaction, causing undersensing of ventricular fibrillation and failure to shock.
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