[Patient with the intervention of an implantable cardioverter-defibrillator in a hospital emergency department].

OBJECTIVE: Introduction: Implantable cardioverter-defibrillators (ICD) improve prognosis in patients with malignant ventricular arrhythmias. Patients with ICD represent a significant proportion of all Emergency Department (ED) admissions. The number of these visits due to the high-energy therapy or antitachycardia pacing (ATP) delivered by the implanted cardioverter-defibrillator is constantly increasing. The aim: To present the prevalence and type of therapeutic interventions of an ICD in patients admitted to ED in 2014-2017 at two medical centers covering approx. 400 000 residents. PATIENTS AND METHODS: Materials and methods: The patients' documentation was analyzed to find patients admitted to emergency department because of the suspicion of the ventricular arrhythmias' therapy delivered by ICD. RESULTS: Results: In most cases adequate high-energy therapies due to life-threatening ventricular arrhythmias were the reason for hospitalization. We identified 126 patients aged 63.0±12.0 years, 108 (86&) of male and 18 (14&) of female. Among 171 ED admissions 6 were associated with ATP and 149 with high-energy therapy, 10 cases presented with VT without therapies, 5 with fantom shocks and in one case the patient had only a pacemaker but not ICD. The number of ICD shocks ranged from 1 to 108. Inadequate ICD discharges were found in 26 (17.4&) of high energy therapies. CONCLUSION: Conclusions:1. The number of patients with ICD admitted to Emergency Department due to the initiation of high-energy or anti-tachyarrhythmic therapy has been steadily increasing in recent years. 2. In most cases, the reason for the admissions are adequate high-energy therapies, i.e. ICD discharges that disrupt the potentially life threatening arrhythmia. 3. Accurate medical history, the possibility of assessing the heart rate stored in the ICD memory during its intervention form the basis for establishing a plan of action in patients with ICD.