Inappropriate shocks from subcutaneous implantable cardioverter-defibrillator induced by chest compressions
Abstract
This article focuses on the case of a 30-year-old patient with subcutaneous implantable cardioverter-defibrillator (S-ICD) implanted after heart transplantation who was resuscitated in a pre-hospital setting. The aim of the text is to introduce the topic of the inappropriate defibrillation shocks delivered by S-ICD due to wrong rhythm analysis of induced artefacts because of chest compressions.
The S-ICD evaluated the artefacts from the chest compressions as a defibrillated rhythm despite the fact that the professional monitor-defibrillator of the Emergency Medical Services (EMS) had evaluated the rhythm as asystole. The defibrillation shocks were delivered by the S-ICD despite the setting of Conditional Shock Zone at 200 beats per minute (bpm) and the Shock Zone at 230 bpm.
The bystander who was providing chest compression was hit by a S-ICD shock and was shaken for several minutes after the shock. The EMS crew was unsuccessful in deactivating the detection of arrhythmias and defibrillation of the S-ICS by placing a magnet over the device.