Phantom shocks: innocent bystander or complication of implantable cardioverter defibrillator therapy?

Implantable cardioverter defibrillators (ICDs) are effective for both primary and secondary prevention of sudden cardiac death. For patients with reduced left ventricular ejection fraction caused by ischaemic or non-ischaemic aetiology, ICDs have received a class I indication in the recent European guidelines [1]. Adherence to the guidelines has led to a steady increase in implantation rates in the Netherlands and Europe over the last years [2]. Health care utilisation even in patients with primary prevention seems to be high [3]. Quality of life (QoL) might not improve after ICD implantation even though there is controversial evidence on this subject. A main determinant of decrease in QoL, at least in a subgroup of patients with ICDs, is the occurrence of adequate and inadequate shocks [4]. The occurrence of phantom shocks is not systematically reported in randomised trials and also largely negated in studies about QoL. …