Pre-hospital management of patients with implantable cardioverter-defibrillators shocks — procedure proposal

Abstract

The number of implantable cardioverter-defibrillators (ICD) has broadened over the years, with indications including conditions like ischaemic and non-ischaemic cardiomyopathies, heart failure, and certain ventricular arrhythmias. Consequently, the number of people with ICDs has risen significantly, necessitating that healthcare professionals and emergency medical services be proficient in handling the distinctive challenges associated with the high-energy shocks delivered by these devices. The article highlights the importance of a structured approach to managing ICD shocks in pre-hospital settings to improve patient outcomes and ensure timely, appropriate care. The article also describes types of cardioverters—defibrillators and the differences between adequate and inappropriate discharges. The article also described the rules in the case of adequate and inappropriate discharges. The management algorithm proposed by the authors may be useful in the care of any patient with an ICD discharge. The authors also recommend that a magnet for deactivating high-energy discharges should be obligatory equipment in every ambulance. In the end, the rules of conduct in the case of patients with an implanted ICD who experience sudden cardiac arrest are described.