Inappropriate ICD Shocks

Inappropriate ICD shocks

Inappropriate implantable cardioverter-defibrillator shocks are one of the commonest adverse effects of ICDs, which can occur in up to about 25% of those implanted with an ICD. Inappropriate shocks can certainly affect the quality of life, especially in those who have not been counseled well earlier regarding the possibility of occurrence of inappropriate shocks prior to implantation. Most often inappropriate shocks are due to misinterpretation of supra-ventricular tachycardias as ventricular, by the device.

Other causes are T wave over-sensing with double counting, electromagnetic interference and lead malfunction with detection of artifacts. Optimal programming of a dual chamber device can reduce the possibility of an inappropriate shock. Pharmacotherapy of supra-ventricular arrhythmias is another useful option.