Inappropriate shock delivery by implantable cardioverter defibrillator due to electrical interference with washing machine

An unusual cause of recurrent syncope in a patient with implantable cardioverter defibrillator

“…While in hospital expected adverse effects of EMI may be prevented however they remain a concern when patients use household appliances or run across certain electrical devices in daily life. Inappropriate ICD discharge in response to electrical noise detected as VF from not properly grounded washing machine has been previously reported [2] , [3] , [4] . In the present case the LIA algorithm avoided inappropriate ICD discharge by automatically prolonging the NID.…”

Inappropriate shock delivery as a result of electromagnetic interference originating from the faulty electrical installation

“…Notice that external EMI usually has lower amplitude on channels recorded from small, closely spaced electrodes ("RV tip to RV ring") than on those recorded from widely spaced electrodes or those that include a large defibrillation electrode ("Can to RV coil") neglected patient with Cardiovascular implantable electronic device (CIED) but noted that interference with pacemakers may occur at levels below the recommended reference levels (International Commission on Non-Ionizing Radiation Protection, 2010). ICDs and modern pacemakers with bipolar sensing configurations seem to be well shielded against external low-frequency magnetic fields and usually EMI is solved using noise algorithms, but there are several examples that electrical leaks or bad grounding can lead to inappropriate ICD shocks (Al Khadra et al, 2006;Chongtham et al, 2007;Shenasa et al, 2018;Tiikkaja et al, 2013). In these cases, patient education and solving the external causes of the problem are essential (Sweesy et al, 2004).…”

Advanced algorithms can lead to electrocardiographic misinterpretations

“…The first hypothesis was an abnormality linked to patient's exposure to electromagnetic interferences [1,[4][5][6]. Pacing, sensing and impedances tested by telemetry were found to be in normal range (Table 1), with no matching with the observed abnormalities.…”

“…It is common knowledge that the presence of electromagnetic interferences is involved in a wide range of devices dysfunction [1][2][3]. Specific settings of pacemaker (PM) are required in order to reduce interference.…”