Inappropriate Implantable Cardioverter-Defibrillation Detection of Ventricular Fibrillation Induced by Transcutaneous Electrical Nerve Stimulation

We describe 2 cases of electromagnetic interference (EMI) with a transcutaneous electrical nerve stimulation (TENS) device in patients with implantable cardioverter-defibrillators (ICDs). Both patients were using DR-HO’S(®) pain therapy system for chronic back pain (VGH Solutions Inc., Markham, ON, Canada). In both cases, EMI was inappropriately labeled as ventricular fibrillation. In the first case, the noise detected was of a short duration and did not fulfill the discriminator criteria to deliver ICD therapy. In the second case, inappropriate anti-tachycardia pacing and shocks resulting from EMI were delivered. Both patients were advised not to use TENS devices at home. Increased awareness of EMI resulting in inappropriate ICD therapies using these devices is needed.