Inappropriate shocks due to air entrapment in patients with subcutaneous implantable cardioverter‐defibrillator: A meta‐summary of case reports

BACKGROUND: Air entrapment has been recently described as a cause of inappropriate shock (IAS) among patients who underwent subcutaneous implantable cardioverter‐defibrillator (S‐ICD) implantation. Data about this complication are lacking in the literature. METHODS: In this meta‐summary 14 case reports describing IAS due to air entrapment were included. Patients' characteristics, S‐ICD implant technique and air entrapment properties were collected. RESULTS: All patients experienced IAS within 4 days following S‐ICD implant. The subcutaneous air was demonstrated by chest x‐ray in 11 cases (73.3%). The sensing vector was reprogrammed in 11 cases (73.3%), and ICD was switched off in 2 cases (1.3%). CONCLUSIONS: IAS due to air entrapment is an early complication of S‐ICD implant. No association was observed between the implant technique and air retention. Diagnosis is confirmed by chest x‐ray and device interrogation. Management includes switching off the device or, preferably, changing the sensing vector.