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Ineffective ICD Therapy Due to Excessive Alcohol and Exercise

PAPAIOANNOU, G.I., et al.: Ineffective ICD Therapy Due to Excessive Alcohol and Exercise. A 49‐yearold man with dilated cardiomyopathy and an ICD received eight unsuccessful shocks for a single episode of ventricular tachycardia after excessive alcohol intake and exercise. The patient had low defibrillation thresholds just 8 days prior to his event during a routine 6‐week postimplant electrophysiological study. Defibrillation threshold testing after his incident confirmed the low energy requirement for ventricular tachycardia termination. A previous animal study reported that intravenous ethanol elevates the defibrillation energy in a dose dependent manner. However, a recent study in humans showed that modest alcohol intake had no effect on defibrillator thresholds. This case report supports the animal data and suggests that excessive alcohol consumption can cause a life‐threatening situation in ICD patients.