The clinical characteristics of patients admitted to the emergency department because of implantable cardioverter defibrillator shock

Abstract

Aim: To present the clinical spectrum of the Emergency Department (ED) patients with presumed electrical shocks. Material and methods: The electronic recordings of the patients admitted to the ED of Unversity Hospital in Wroclaw between April 2020 and June 2021 were searched for the words: discharge, electrical storm, syncope, con¬vulsions. The received patients recordings were checked and all patients with electrical shocks from implantable cardioverter defibrillators (ICDs) both real and presumed were included into the study. Patients were divided into three groups: patients hospitalized due to adequate ICD discharges, patients hospitalized for other reason who had adequate interventions in the ICD memory and patients with incorrectly diagnosed ICD interventions. Results: The study group consisted of 26 patients. There was 18 men aged 65.9±10.9 and 8 women aged 68.1±12.4 (p=0.66). A total of 20 patients had electrical shocks confirmed by ICD memory checking and 6 patients had no ICD shocks. Conclusions: ED visits due to discharges of ICDs are rare. The medical history of ICD discharge could be misleading, because some patients interpret different symptoms or acoustic signals of the ICDs as a discharge. The ICD patients with syncope, unconsciousness, history of seizures should have their ICD checked for the possible discharges.