Combined use of a true-bipolar sensing implantable cardioverter defibrillator in a patient having a prior implantable spinal cord stimulator for intractable pain

Reported is a case involving a patient with a previously implanted spinal c ord stimulator (SCS) who presented for an implantable cardioverter defibril lator (ICD), The SCS device was located in the left lower abdominal quadran t with a stimulation electrode array placed on the dorsal aspect of the spi nal cord at the T-11 thoracic level. interaction testing demonstrated that the bipolar sensing transvenous ICD system (Medtronic 7221Cx PCD) did not d etect the stimulator's output at burst rates ranging from 20-130 pulses/s, even with the ICD set to its maximum sensitivity of 0.15 m V and the stimul ator programmed to the highest patient tolerated output combinations of 5 V , 0.45 ms in the bipolar configuration and 3 V, 0.45 ms in the unipolar (i. e., case-electrode) configuration.