S-ICD lead dislodgement in a young isometric athlete: A rare complication

Pacing Clin Electrophysiol. 2020 Aug;43(8):898-900. doi: 10.1111/pace.13965. Epub 2020 Jun 3.

Abstract

The subcutaneous implantable cardioverter defibrillator (S-ICD) is an alternative to transvenous ICD in patients who do not need cardiac pacing. We report the case of a young isometric athlete who received S-ICD for primary prevention of sudden death. Lead dislodgement and myopotential noise oversensing during isometric training led to inappropriate shock, and a surgical revision was performed. During the procedure, strong fibrous adhesions were found, requiring polytetrafluoroethylene dilator sheaths. The S-ICD was finally reimplanted. Despite continued isometric training, no more myopotential oversensing occurred after 1-year follow-up. The present case highlights the possible higher risks of lead complication in an isometric athlete and the uncommon effort in removing an old-generation subcutaneous defibrillator lead.

Keywords: defibrillator; isometric exercise; lead dislodgement; myopotential; subcutaneous implantable cardioverter defibrillator.

Publication types

  • Case Reports

MeSH terms

  • Athletes
  • Brugada Syndrome / physiopathology
  • Brugada Syndrome / therapy*
  • Death, Sudden, Cardiac / prevention & control*
  • Defibrillators, Implantable / adverse effects*
  • Electrocardiography
  • Equipment Failure*
  • Fluoroscopy
  • Humans
  • Male
  • Primary Prevention
  • Reoperation
  • Weight Lifting
  • Young Adult