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.