"Magnetic attraction" in the pediatric emergency department: the case of a malfunctioning implantable cardioverter-defibrillator.
The use of implantable cardioverter-defibrillators (ICDs) in pediatric patients has increased substantially over the past 3 decades. We report the case of a 15-year-old boy with congenital heart disease who presented with recurrent inappropriate ICD shocks due to a lead malfunction. Inaccessibility of a magnet to inactivate shock therapy in the pediatric emergency department (PED) resulted in numerous additional inappropriate shocks. Herein, we provide a brief overview of ICD care relevant to the PED. The complexities of these devices and their associated therapies require pediatric emergency physicians caring for these patients to recognize basic ICD functions and troubleshoot malfunctions to provide timely management. In particular, it is essential that PEDs be equipped with magnets and that physicians are trained in their appropriate use.
Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada.
Virginie Beauséjour
VB
Ladouceur
Paul
P
Khairy
Marie J
MJ
Béland
Farhan
F
Bhanji
D000293:Adolescent; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D004556:Electric Injuries / Q000209:etiology*; D004868:Equipment Failure; D006801:Humans; D059346:Magnets; D008297:Male; D017180:Tachycardia, Ventricular / Q000628:therapy