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An Appropriately-Inappropriate Cardiac “Shock”

He was 60-year-old man who underwent surgery for an implantable cardiac defibrillator (ICD) approximately 3 years prior who was returning to the clinic for routine followup. He felt well and had no other complaints.

He was connected to the EKG and the programmer’s wand was placed over the device. I interrogated his device and when the initial screen appeared, there it was — a single shock from his device, received two weeks ago.

“Mr. Smith, are you aware that you had an ICD shock about two weeks ago?”

“Yeah.”

“Why didn’t you call us?”

“I don’t know.”

“Did it bother you?”

“Not really.”

“Why not?”

There was a pause. I looked up from the programmer and took a quick look at him. He was looking away. Instantly, I realized the answer.

“Never mind,” I answered. “Here, I’ll just change the VT detect rate.”

“No, doc, please don’t. Leave the settings as they are.”

“Are you sure?”

“Absolutely.” He looked at me as I doubted him. “Seriously doc, I mean it.”

“How come?”

“She liked it.”

-WesMusings of a cardiologist and cardiac electrophysiologist

*This blog post was originally published at Dr. Wes*


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