Inappropriate ICD shock due to hot tub-induced external electrical interference.
BACKGROUND
A 72-year-old white male with a history of rapid nonsustained ventricular tachycardia, hypertrophic cardiomyopathy, and intermittent Brugada-type ECG had a single-lead implantable cardioverter-defibrillator (ICD) implantation and received a sudden ICD shock while in the hot tub. To the best of our knowledge this is the first case report of hot tub jet-induced inappropriate ICD shock.


METHODS
ICD interrogation and analysis of intracardiac electrograms and event markers.


RESULTS
ICD interrogation revealed inappropriate ICD shocks due to electrical interference of hot tub engine; 60-cycle electrical artifact mimicking fast ventricular fibrillation erroneously detected by the device. The device then delivered a 34.8 joules shock while the patient was actually in sinus rhythm.


CONCLUSIONS
Electrical interference due to external sources such as hot tub engines may occur and produce an inappropriate detection and ICD shock. Precaution and patient education is warranted.
['Shenasa|Mohammad|M|', 'Heidary|Shahriar|S|', 'Shenasa|Hossein|H|']
D000368:Aged D001494:Baths D053840:Brugada Syndrome D002312:Cardiomyopathy, Hypertrophic D017147:Defibrillators, Implantable D004562:Electrocardiography D004868:Equipment Failure D006358:Hot Temperature D006801:Humans D008297:Male D017180:Tachycardia, Ventricular
Inappropriate ICD shock Electrical interference Implantable cardioverter-defibrillator