A patient in their late teens presented to the outpatient department stating that they had felt the implanted cardioverter defibrillator (ICD) deliver a shock 3 times within the past 6 months. The patient had a history of cardiac arrest due to ventricular fibrillation and had received an ICD 20 months ago. On admission, the patient’s vital signs were as follows: temperature, 36.4 °C; blood pressure, 114/69 mm Hg; pulse rate, 70 beats/min; and respiratory rate, 18 breaths/min. Cardiopulmonary examination was unremarkable. Troponin I, N-terminal probrain natriuretic peptide (NT-pro BNP), and D-dimer levels were normal. The 12-lead electrocardiogram (ECG) obtained at admission is shown in the Figure.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Yuan Zhang, MD, Department of Cardiology, Haining People’s Hospital, No. 2 West Qianjiang Rd, Haining 314400, Zhejiang Province, China (firstname.lastname@example.org).
Published Online: April 17, 2023. doi:10.1001/jamainternmed.2023.0294
Conflict of Interest Disclosures: None reported.
Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:
It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.
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