Journal of Arrhythmia (Aug 2019)

Early inappropriate shock in a subcutaneous cardiac defibrillator due to subcutaneous air

  • Ryo Nishinarita,
  • Jun Kishihara,
  • Gen Matsuura,
  • Yuki Arakawa,
  • Shuhei Kobayashi,
  • Yuki Shirakawa,
  • Ai Horiguchi,
  • Hironori Nakamura,
  • Naruya Ishizue,
  • Jun Oikawa,
  • Hidehira Fukaya,
  • Shinichi Niwano,
  • Junya Ako

DOI
https://doi.org/10.1002/joa3.12210
Journal volume & issue
Vol. 35, no. 4
pp. 682 – 684

Abstract

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Abstract A 57‐year‐old man was admitted to our hospital due to syncopal attack. He was diagnosed with Brugada syndrome due to which a subcutaneous implantable cardiac defibrillator (S‐ICD) was inserted using the standard technique. Two hours after the implantation, he experienced inappropriate shock while conscious. Device interrogation revealed a contentious baseline shift and frequent oversensing of low‐amplitude signals, which was followed by a shock. Lateral chest X‐ray revealed subcutaneous air surrounding the proximal electrode. Another inappropriate shock could be avoided by changing the sensing vector. The subcutaneous air was completely resolved 7 days after implantation.

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