Intra-Abdominal Hemorrhage Triggering Inappropriate Therapy From a Subcutaneous Defibrillator

Michael M Malaty; Max Ray; David Ferreira; Gwilym M Morris; Nicholas Jackson

doi:10.1016/j.jaccas.2023.102167

Intra-Abdominal Hemorrhage Triggering Inappropriate Therapy From a Subcutaneous Defibrillator

JACC Case Rep. 2023 Dec 20;29(3):102167. doi: 10.1016/j.jaccas.2023.102167. eCollection 2024 Feb 7.

Authors

Michael M Malaty¹, Max Ray¹, David Ferreira^{1

2}, Gwilym M Morris^{1

2

3}, Nicholas Jackson^{1

2}

Affiliations

¹ Department of Cardiology, John Hunter Hospital, New Lambton, New South Wales, Australia.
² School of Medicine, University of Newcastle, New South Wales, Australia.
³ Hunter Medical Research Institute, New Lambton, New South Wales, Australia.

Abstract

The SMART Pass filter (Boston Scientific) aims to reduce inappropriate shocks (IASs) from subcutaneous implantable cardioverter-defibrillators by filtering out low-frequency signals such as T waves. However, this filter is deactivated in the presence of diminished R-wave sensing. We describe a case of IAS in the setting of extensive intra-abdominal hemorrhage.

Keywords: SMART Pass algorithm; inappropriate shock; subcutaneous ICD.

Publication types

Case Reports