The automatic implantable cardioverter-defibrillator (A1CD) (CPI Inc.) is effective in reducing the yearly mortality rate for malignant tachyarrhythmias to about 2%.1 Inappropriate AICD discharges may occur in response to unsustained ventricular tachyarrhythmias,2 sinus and other supraventricular tachycardias and interaction with an implanted pacemaker during programming3 as a consequence of the inherent limitations of AICD design. We exploited these design characteristics to intervene therapeutically during tachycardias at rates below those ordinarily detected by the AICD. Electrical chest wall stimulation with a low-amplitude pacer stimulus is a standard means of triggering and inhibiting conventional implanted pacemakers. This report describes the use of chest wall stimulation to elicit a therapeutic AICD discharge on several occasions.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine