Understanding Phantom Shocks in Implantable Cardioverter-Defibrillator Recipients

Abstract

Phantom shocks in implantable cardioverter-defibrillator (ICD) recipients create a complex nexus between cardiac treatment and psychological distress. These sensations, mimicking therapeutic shocks without device activation, deeply affect patients' functionality and well-being. Heightened anxiety, depression, and hopelessness predispose individuals to these occurrences, posing significant challenges. This article delves into the intricate nature of phantom shocks, highlighting subtle clinical cues to differentiate them from genuine therapy shocks. Through a case study of a 75-year-old male with recurrent ICD shocks, diagnosed eventually with phantom shocks, the interplay between psychological distress and physical sensations is underscored. Urgent intervention to address the patient's anxiety and depression using psychotherapy and antidepressants became imperative. The case underscores the immense psychological toll of phantom shocks, exacerbating fear, hopelessness, and post-traumatic stress disorder (PTSD). Despite treatment attempts, their impact persisted, leading to a shift to comfort-focused care. While research identifies factors such as education levels and prior therapy, predicting and managing phantom shocks remains challenging. This article stresses the need for clinician vigilance, urging proactive identification and tailored interventions to mitigate the profound effects of phantom shocks. The current research landscape lacks comprehensive strategies, necessitating further exploration and targeted therapies to restore patient well-being. In conclusion, comprehensive understanding and specialized care for phantom shocks in ICD recipients, addressing both cardiac and psychological aspects, are imperative. Early recognition and tailored interventions offer promise in alleviating their adverse effects, reinstating patient control, and improving their quality of life.

Keywords: cardiac-psychological nexus; implantable cardioverter-defibrillator (icd); phantom shocks; psychological distress; therapy shock differentiation.

Figure 1. Case timeline

ICD=Implantable Cardioverter-Defibrillator; VT=Ventricular Tachycardia

Figure 2. Distinguishing genuine ICD shocks from phantom shocks

Image Credits: Jason Galo, MD (Author)