Cardiology Letters 2018, 27(5):252-256

Inappropriate shocks from subcutaneous implantable cardioverter-defibrillator induced by chest compressions

Cmorej PCH¹, Smržová E¹, Bulíková T², Peřan D³, Kohlová A⁴, Fleischmann O⁵

¹ Zdravotnické záchranné služby Ústeckého kraje, p. o., Ústí nad Labem, Česká republika

² Slovenskej zdravotníckej univerzita v Bratislave, Fakulta ošetrovateľstva a odborných zdravotníckych štúdií, Záchranná zdravotná služba Life Star Emergency, Limbach, Slovenská republika

³ Zdravotnické záchranné služby hlavního města Prahy, Kabinet veřejného zdravotnictví, 3. lékařská fakulta, Univerzita Karlova v Praze, Česká republika

⁴ Univerzita Jana Evangelisty Purkyně, Fakulta zdravotnických studií, Ústí nad Labem, Česká republika

⁵ Zdravotnické záchranné služby Ústeckého kraje, p. o., Ústí nad Labem, Česká republika, Univerzita Jana Evangelisty Purkyně, Pedagogická fakulta, Ústí nad Labem, Česká republika

This article focuses on the case of a 30-year-old patient with subcutaneous implantable cardioverterdefibrillator (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. Literature search did not find any similar case reports about the inappropriate defibrillation shocks delivered by S-ICD due to wrong rhythm analysis because of chest compressions induced artefacts.

Keywords: defibrillator; inappropriate shock; resuscitation; subcutaneous implantable cardioverter-

Published: May 1, 2018  Show citation