Central venous access resulting in selective failure of ICD defibrillationcapacity

In a patient with a defibrillator system incorporating a lead with integrat ed bipolar sensing, physical contact between a guidewire (inserted for veno us access) and the right ventricular defibrillation coil created sensing ar tefacts that triggered an inappropriate discharge. The presence of the guid ewire in the heart during the discharge resulted in an electrical short wit h irreversible damage to the generator and rendered it incapable of deliver ing further high voltage therapy.