A 61-year-old male presented to the emergency room with a gunshot wound to the upper left chest. He had a history of myocardial infarction, two coronary bypass graft surgeries, and intracoronary stents. The patient had chronic ischemic cardiomyopathy with a left ventricular ejection fraction of 24%. He received a Medtronic Virtuoso-DR D154AWG (Minneapolis, MN) transvenous implantable cardioverter-defibrillator (ICD) in 2007 for primary prophylaxis. Since implantation, he had never received ICD therapy but did atrial pace frequently. The ICD had been interrogated 2 weeks prior and was found to function normally. Despite the gunshot wound with an entry to the chest located just medial to the ICD generator, the patient remained alert with stable vital signs and virtually no symptoms.-Wes
Reference: Sheppard RC, Levine JC, Rovin J and van Gelder HM. "A novel way an implantable cardioverter-defibrillator prevents death: Protection from a gunshot" Heart Rhythm Volume 6, Issue 9, September 2009, Page 1390.