Morrison Nathan, Voleti Navya, Cannizzaro Michael
Emergency Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
Cureus. 2023 Mar 1;15(3):e35634. doi: 10.7759/cureus.35634. eCollection 2023 Mar.
An implantable cardioverter defibrillator (ICD) can save lives from fatal tachyarrhythmias. In rare cases, these devices can fail or malfunction. We present a case of a patient that suffered from 25 inappropriate shocks and 22 episodes of antitachycardia pacing (ATP), secondary to a probable non-traumatic dual lead fracture. One episode of ATP induced an R-on-T phenomenon, causing monomorphic ventricular tachycardia in the patient. The inappropriately functioning ICD also required two magnets to be placed on the patient's chest in the emergency department to convert the device to an asynchronous mode. An unexpected case of this magnitude and in such a brief timeframe has not been reported in prior ICD studies.
植入式心脏复律除颤器（ICD）可挽救致命性快速心律失常患者的生命。在极少数情况下，这些装置可能会出现故障或功能失常。我们报告一例患者，因可能的非创伤性双导联断裂，该装置出现了25次不恰当电击和22次抗心动过速起搏（ATP）发作。一次ATP发作诱发了R-on-T现象，导致患者出现单形性室性心动过速。功能失常的ICD在急诊科还需要在患者胸部放置两块磁铁，以便将该装置转换为异步模式。此前的ICD研究中尚未报道过如此严重且在如此短时间内发生的意外病例。
