Anshu Man Singh, Shubham Srivastava, Roopali Khanna, Aditya Kapoor
Implantable cardioverter-defibrillators (ICDs) are effective in preventing sudden cardiac death; however, lead-related complications remain an important cause of device malfunction. Lead fracture may result in oversensing and inappropriate shocks, significantly affecting patient morbidity. We report a 48-year-old man with ischemic cardiomyopathy and a single-chamber ICD who presented with multiple inappropriate shocks following a motor vehicle accident. Device interrogation demonstrated high-frequency non-physiological noise, abrupt reduction in lead impedance, and premature battery depletion. Fluoroscopy confirmed ventricular lead fracture. The fractured lead was abandoned, and a new ventricular lead was successfully implanted. Inappropriate shocks resolved completely following lead revision. Trauma-related lead fracture should be considered in patients presenting with inappropriate ICD therapies after blunt chest trauma. Prompt device interrogation and lead revision are essential for appropriate management.