The hot can: ICD failure presenting as severe shoulder pain.
We describe a patient whose presentation of ICD generator failure was excruciating shoulder pain lasting 3 hours. This painful episode prompted evaluation and subsequent generator replacement. Destructive analysis of the explanted device revealed a short circuit of three battery filter capacitors, which resulted in the battery "dumping" its full energy very rapidly, since the impedance across the battery terminal was < 1 ohm. The duration of the painful episode was equal to the estimated ICD battery life under this low impedance condition.
Joglar
J A
JA
Department of Internal Medicine (Cardiology, Clinical Cardiac Electrophysiology), University of Texas Southwestern Medical Center, Rm. CS7.102, 5323 Harry Hines Blvd., Dallas, TX 75390-9047, USA. jajogl@parknet.pmh.org
Kowal
R C
RC
Brown
T
T
Van Horn
B
B
Page
R L
RL
D000328:Adult; D001365:Axilla; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D010146:Pain / Q000209:etiology*; D012782:Shoulder