Abstract
We had presented the case of a 30-year-old man who suffered sudden out-of-hospital cardiac arrest and in whom chest compressions induced inappropriate shocks by the S-ICD (EMBLEM MRI S-ICD, Boston Scientific) with a Conditional Shock Zone programmed at 200 beats/min and a Shock Zone programmed at 230 beats/min. Upon arrival, the paramedics verified cardiac arrest and continued resuscitation according to the 2015 European Resuscitation Council Guidelines.
Initial analysis did not recommend delivering a shock due to the presence of asystole. The EMS crew asked a bystander to perform chest compressions.
In the fifth minute of resuscitation, the patient suddenly received a shock from the S-ICD (Fig. 1). The bystander performing chest compressions received a shock delivered by the S-ICD.
This was so unpleasant that the bystander refused to continue with chest compressions. He underwent a medical examination after this incident, which fortunately did not reveal any damage to his health.
Subsequently, the EMS crew found the S-ICD device on the left side of the patient's chest in the mid-axillary line - until this accident they had not been aware of it. The patient also received several inappropriate shocks during the resuscitation.