Introduction: Sudden cardiac death and ventricular arrhythmias have been observed in response to disasters associated with intense emotion. Even modest activities can provide sufficient sympathetic nervous system activation to trigger cardiovascular events. Sympathetic stimulation acting through ?-adrenergic receptors may be proarrhythmic with several mechanisms. We present the case of implantable cardioverter–defibrillator (ICD) shocks during a robbery.
Methods: A 58-year-old man with a history of dilated cardiomyopathy and severe dysfunction of ejection fraction ( < 30% EF) had an ICD implantation in April 2013. His ICD was an Incepta F160 (Boston Scientific) and the ICD lead was an Endotak Reliance G 0285(Boston Scientific). In March 2015 he experienced three distinct device discharges while a robber with a gun ordered him to hand over his money.
Results: The LATITUDE Remote Patient Management system communicated at home three 41-J appropriate shocks with shocking lead impedances of 46, 47 and 48 Ohm. He described chest pain, palpitations, fear and anger.
Conclusions: Psychological distress and negative emotions are important factors in the development of arrhythmia and this case report is presented to add to the existing literature