Netherlands Heart Journal

, Volume 21, Issue 4, pp 191–195 | Cite as

Incidence and predictors of phantom shocks in implantable cardioverter defibrillator recipients

  • K. KraaierEmail author
  • A. H. Starrenburg
  • R. M. Verheggen
  • J. van der Palen
  • M. F. Scholten
Original Article



Implantable cardioverter defibrillators (ICDs) are designed to deliver shocks or antitachycardia pacing (ATP) in the event of ventricular arrhythmias. During follow-up, some ICD recipients experience the sensation of ICD discharge in the absence of an actual discharge (phantom shock). The aim of this study was to evaluate the incidence and predictors of phantom shocks in ICD recipients.


Medical records of 629 consecutive patients with ischaemic or dilated cardiomyopathy and prior ICD implantation were studied.


With a median follow-up of 35 months, phantom shocks were reported by 5.1 % of ICD recipients (5.7 % in the primary prevention group and 3.7 % for the secondary prevention group; p=NS). In the combined group of primary and secondary prevention, there were no significant predictors of the occurrence of phantom shocks. However, in the primary prevention group, phantom shocks were related to a history of atrial fibrillation (p=0.03) and NYHA class <III (p=0.05). In the secondary prevention group, there were no significant predictors for phantom shocks.


Phantom shocks occur in approximately 5 % of all ICD recipients. In primary prevention patients, a relation with a history of atrial fibrillation and NYHA class <III were significant predictors for the occurrence of phantom shocks. In the secondary prevention patients, no significant predictors were found.


Implantable defibrillator Primary prevention Secondary prevention Phantom shock Psychological consequences 


Conflicts of interest & funding



  1. 1.
    Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877–83.CrossRefGoogle Scholar
  2. 2.
    Lee DS, Green LD, Liu PP, et al. Effectiveness of implantable defibrillators for preventing arrhythmic events and death: a meta-analysis. J Am Coll Cardiol. 2003;41(9):1573–82.CrossRefGoogle Scholar
  3. 3.
    Bardy GH, Lee KL, Mark DB, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352(3):225–37.CrossRefGoogle Scholar
  4. 4.
    Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(10):e385–484.CrossRefGoogle Scholar
  5. 5.
    van Welsenes GH, Borleffs CJ, van Rees JB, et al. Improvements in 25 years of implantable cardioverter defibrillator therapy. Neth Heart J. 2011;19(1):24–30.CrossRefGoogle Scholar
  6. 6.
    Kowey PR, Marinchak RA, Rials SJ. Things that go bang in the night. N Engl J Med. 1992;327(26):1884.CrossRefGoogle Scholar
  7. 7.
    Swygman CA, Link M, Cliff D, et al. Incidence of phantom shocks in patients with implantable cardioverter defibrillators. Pacing Clin Electrophysiol. 1998;21:810. Ref Type: Abstract.Google Scholar
  8. 8.
    Wojcicka M, Lewandowski M, Smolis-Bak E, et al. Psychological and clinical problems in young adults with implantable cardioverter-defibrillators. Kardiol Pol. 2008;66(10):1050–8.PubMedGoogle Scholar
  9. 9.
    Bhandari AK, Anderson JL, Gilbert EM, et al. Correlation of symptoms with occurrence of paroxysmal supraventricular tachycardia or atrial fibrillation: a transtelephonic monitoring study. The Flecainide Supraventricular Tachycardia Study Group. Am Heart J. 1992;124(2):381–6.CrossRefGoogle Scholar
  10. 10.
    Kang Y. Relation of atrial arrhythmia-related symptoms to health-related quality of life in patients with newly diagnosed atrial fibrillation: a community hospital-based cohort. Heart Lung. 2006;35(3):170–7.CrossRefGoogle Scholar
  11. 11.
    Prudente LA, Reigle J, Bourguignon C, et al. Psychological indices and phantom shocks in patients with ICD. J Interv Card Electrophysiol. 2006;15(3):185–90.CrossRefGoogle Scholar
  12. 12.
    van den Broek KC, Nyklicek I, van der Voort PH, et al. Shocks, personality, and anxiety in patients with an implantable defibrillator. Pacing Clin Electrophysiol. 2008;31(7):850–7.CrossRefGoogle Scholar
  13. 13.
    Jacob S, Panaich SS, Zalawadiya SK, et al. Phantom shocks unmasked: clinical data and proposed mechanism of memory reactivation of past traumatic shocks in patients with implantable cardioverter defibrillators. J Interv Card Electrophysiol. 2012;34(2):205–13.CrossRefGoogle Scholar
  14. 14.
    Erdman RA, Pedersen SS. Clinical and scientific progress related to the interface between cardiology and psychology: lessons learned from 35 years of experience at the Thoraxcenter of the Erasmus Medical Center in Rotterdam. Neth Heart J. 2011;19(11):470–6.CrossRefGoogle Scholar

Copyright information

© Springer Media / Bohn Stafleu van Loghum 2012

Authors and Affiliations

  • K. Kraaier
    • 1
    Email author
  • A. H. Starrenburg
    • 2
  • R. M. Verheggen
    • 1
  • J. van der Palen
    • 3
    • 4
  • M. F. Scholten
    • 1
  1. 1.Department of Cardiology, Thoraxcenter TwenteMedisch Spectrum TwenteEnschedethe Netherlands
  2. 2.Department of PsychologyMedisch Spectrum TwenteEnschedethe Netherlands
  3. 3.Department of EpidemiologyMedisch Spectrum TwenteEnschedethe Netherlands
  4. 4.Department of Research methodology, Methods and Data AnalysisUniversity of TwenteEnschedethe Netherlands

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