ArticleJACC. Case reports2026
Baroreflex Activation Therapy and Subcutaneous ICDs: A Manageable Electrical Mismatch.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
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Abstract
backgroundBaroreflex activation therapy (BAT) improves symptoms and quality of life in patients with heart failure with reduced ejection fraction, while subcutaneous implantable cardioverter-defibrillators (S-ICDs) protect against sudden cardiac death without intravascular hardware. Unipolar BAT stimulation poses a theoretical risk of interference with S-ICD sensing. CASE SUMMARY: A 52-year-old man with heart failure with reduced ejection fraction, end-stage renal disease on dialysis, and an S-ICD underwent BAT implantation. During routine hemodialysis, he experienced ventricular fibrillation arrest that the S-ICD failed to detect, misclassifying the rhythm as atrial fibrillation. Device interrogation revealed high-frequency artifact corresponding to BAT output at 6 mA. BAT output was reduced to 1 mA, and S-ICD vectors were reprogrammed. Three months later, the S-ICD appropriately detected and terminated sustained monomorphic ventricular tachycardia. DISCUSSION: BAT-S-ICD interference can result in arrhythmia undersensing. With increasing adoption of both therapies, structured compatibility testing, individualized programming, and multidisciplinary follow-up are critical. TAKE-HOME MESSAGE: Concurrent S-ICD and BAT use is feasible with careful testing and output optimization.
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