Inappropriate ICD Shocks caused by T-wave Oversensing due to Acute Alcohol Intoxication

T-wave oversensing can be a serious problem that often results in inappropriate device therapy. We report here a patient with binge alcohol use who received multiple, inappropriate ICD shocks due to T-wave oversensing from repolarization changes induced by acute alcohol intoxication and no other relevant metabolic derangements. Following recovery from his alcohol intoxication a few days later, the T-wave amplitude decreased so the device no longer inappropriately sensed or delivered therapies. This case represents an uncommon, but reversible, cause of T-wave oversensing that should be considered before more aggressive measures are taken to correct the abnormality. (PACE 2012; 35:e267-e271).