Implantable cardioverter defibrillator shock embolizes an atrial septal occluder device in Brugada syndrome.
Implantable cardioverter defibrillators (ICDs) are indicated in patients with Brugada syndrome with resuscitated ventricular arrhythmias. When these patients have atrial septal defects, they also need closure to prevent paradoxic embolism of thrombus from the defibrillator leads. A 15-year-old boy with Brugada syndrome had transvenous ICD placement along with device closure of a large atrial septal defect. When the defibrillation threshold was checked during device testing, a shock was delivered to terminate the induced ventricular fibrillation. The sudden jerk during this shock resulted in device embolization into the left atrium. The device was successfully retrieved and the defect closed with a larger device. This report discusses this extremely rare association of Brugada syndrome with atrial septal defect, unreported complications after device closure, and successful management of the problem.
Department of Pediatric Cardiology, MIOT Hospital, 4/112, Mount Poonamalle Road, Chennai, 600089, India, drkumarsiva@hotmail.com.
Kothandam
K
Sivakumar
Sreeja
S
Pavithran
Amal
A
Louis
Radhakrishnan
R
Satish
D000293:Adolescent; D053840:Brugada Syndrome / Q000503:physiopathology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000379:methods; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal / Q000379:methods; D004562:Electrocardiography; D004617:Embolism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006325:Heart Atria; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D055989:Septal Occluder Device