title: Ineffective ICD therapy due to excessive alcohol and exercise.
abstract: A 49-year-old man with dilated cardiomyopathy and an ICD received eight unsuccessful shocks for a single episode of ventricular tachycardia after excessive alcohol intake and exercise. The patient had low defibrillation thresholds just 8 days prior to his event during a routine 6-week postimplant electrophysiological study. Defibrillation threshold testing after his incident confirmed the low energy requirement for ventricular tachycardia termination. A previous animal study reported that intravenous ethanol elevates the defibrillation energy in a dose dependent manner. However, a recent study in humans showed that modest alcohol intake had no effect on defibrillator thresholds. This case report supports the animal data and suggests that excessive alcohol consumption can cause a life-threatening situation in ICD patients.
authors.affiliation: Division of Cardiology, Hartford Hospital, Connecticut 06102-5037, USA.
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Papaioannou
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kluger
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000628:therapy*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D015444:Exercise; D006801:Humans; D008297:Male; D008875:Middle Aged