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THE RUNAWAY DEFIBRILLATOR A CASE OF AN IMPLANTABLE CARDIAC DEFIBRILLATOR THAT FAILED COMMUNICATION AND DEACTIVATION WITH A MAGNET
A736 JACC March 17, 2015 Volume 65, Issue 10S
FIT Clinical Decision Making The Runaway Defibrillator... A Case of an Implantable Cardiac Defibrillator That Failed Communication and Deactivation with a Magnet Poster Contributions Poster Hall B1 Monday, March 16, 2015, 9:45 a.m.-10:30 a.m. Session Title: FIT Clinical Decision Making: Arrhythmias and Pericardial Disease Abstract Category: Arrhythmias and Clinical EP Presentation Number: 1248-135 Authors: Mahmoud Assaad, Ahmad Daraghmeh, Christian Machado, Providence Hospital, Southfield, MI, USA
Background: Implantable cardiac defibrillators are indicated for the primary prevention of sudden cardiac death in Systolic Heart Failure patients with left ventricular ejection fraction ≤ 35% and New York Heart Association functional class II or III on optimal medical management. We present a rare case of an Implantable Cardiac Defibrillator malfunction during a routine check-up that failed Wi-Fi and wand interrogation triggering inappropriate shock delivery in Sinus Rhythm, non-suppressible by direct magnet application.
Case: A 60 y.o man presented for routine visit to our device clinic. Upon arrival, our technician could not communicate with the patient’s implantable cardiac defibrillator using a functioning programmer. Conventional office electrocardiogram tracing showed sinus rhythm. Shortly thereafter, the patient experienced multiple shocks documented via telemetry to be inappropriate. The technician per protocol placed a magnet on the device but this failed to deactivate it. The patient was then urgently taken to the electrophysiology lab where he underwent emergency intervention and generator change out. During the procedure he continued to receive inappropriate shocks until the “runaway defibrillator” was disconnected. The faulty device was sent to the company for analysis to identify the mystery behind this first reported case of Implantable Cardiac Defibrillator interrogation and magnet deactivation failure. We believe this is the first reported case of this nature requiring emergency generator change.
FIT Clinical Decision Making The Runaway Defibrillator... A Case of an Implantable Cardiac Defibrillator That Failed Communication and Deactivation with a Magnet Poster Contributions Poster Hall B1 Monday, March 16, 2015, 9:45 a.m.-10:30 a.m. Session Title: FIT Clinical Decision Making: Arrhythmias and Pericardial Disease Abstract Category: Arrhythmias and Clinical EP Presentation Number: 1248-135 Authors: Mahmoud Assaad, Ahmad Daraghmeh, Christian Machado, Providence Hospital, Southfield, MI, USA
Background: Implantable cardiac defibrillators are indicated for the primary prevention of sudden cardiac death in Systolic Heart Failure patients with left ventricular ejection fraction ≤ 35% and New York Heart Association functional class II or III on optimal medical management. We present a rare case of an Implantable Cardiac Defibrillator malfunction during a routine check-up that failed Wi-Fi and wand interrogation triggering inappropriate shock delivery in Sinus Rhythm, non-suppressible by direct magnet application.
Case: A 60 y.o man presented for routine visit to our device clinic. Upon arrival, our technician could not communicate with the patient’s implantable cardiac defibrillator using a functioning programmer. Conventional office electrocardiogram tracing showed sinus rhythm. Shortly thereafter, the patient experienced multiple shocks documented via telemetry to be inappropriate. The technician per protocol placed a magnet on the device but this failed to deactivate it. The patient was then urgently taken to the electrophysiology lab where he underwent emergency intervention and generator change out. During the procedure he continued to receive inappropriate shocks until the “runaway defibrillator” was disconnected. The faulty device was sent to the company for analysis to identify the mystery behind this first reported case of Implantable Cardiac Defibrillator interrogation and magnet deactivation failure. We believe this is the first reported case of this nature requiring emergency generator change.