Inappropriate ICD shocks do not induce pro-arrhythmic electrocardiographic changes in men.

OBJECTIVES: Longer-term electrocardiographic effects of multiple inappropriate ICD shocks were investigated to study their hypothesized pro-arrhythmic potential.

DESIGN: Thirteen male patients with ischemic cardiomyopathy who received ≥2 inappropriate shocks within 24 h and for whom 12-lead ECGs were available both before and within 72h after the inappropriate shocks were analyzed. Exclusion criteria included continuous ventricular pacing, underlying AF, events within 6 weeks after lead implantation and concomitant acute medical problems.

RESULTS: A total of 149 inappropriate shocks (mean 11 ± 19) were received. There were no significant differences in any of the measured intervals or morphological indices, nor was there a correlation between the "before-after" differences and the number of shocks received. Non-significant changes showed Percentage of Loop Area increase and relative T-wave Residuum decrease while the opposite changes have previously been associated with arrhythmic risk.

CONCLUSIONS: No potentially pro-arrhythmic electrocardiographic changes were found 19 h after multiple inappropriate shocks.