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Inappropriate shock and percutaneous cardiac intervention: A lesson to learn in the cath lab
Authors:Giuseppe Di Stolfo  Sandra Mastroianno  Raimondo Massaro  Carlo Vigna  Aldo Russo  Domenico Rosario Potenza
Abstract:Coronary disease is a common condition in patients affected by heart failure with severely reduced ejection fraction (HFrEF). This condition represents an indication for implantable cardioverter defibrillator (ICD) in order to reduce the risk of sudden death related to arrhythmias. Nevertheless, inappropriate shocks are associated with worse quality of life, hospitalization, and death. We present the case of an inappropriate shock related to percutaneous coronary intervention during the insertion and advancement of the guidewire into the left anterior descending artery (LAD) in a patient with an ICD. Physicians’ awareness about the clinical implication of noise arising during a coronary procedure is very important in patients with an ICD or pacemaker, to avoid inappropriate shock or pacing inhibition and to raise the possibility of lead implantation in or helix protrusion into the coronary lumen.
Keywords:inappropriate shock  ICD implantation  percutaneous coronary intervention
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