skip to main content

ICD Post-Shock Interrogation — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModerateAnaesthetic Equipment & SafetyICD Post-Shock InterrogationFRCA Final

A 70-year-old man (ASA IV) with end-stage heart failure (EF 15%) and a biventricular pacemaker (CRT-D) requires palliative debridement of a leg wound under regional anaesthesia. His ICD component fires appropriately once during the procedure due to a genuine VT episode which self-terminates. After the procedure, what post-operative action is required regarding his device?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Replace the device immediately

Any ICD that has delivered a shock (appropriate or inappropriate) during or around a procedure must be interrogated by the cardiac physiology/device team before discharge. This is to: verify the shock was appropriate (review stored electrograms), check lead integrity, assess remaining battery life (shocks consume significant battery), ensure detection and therapy parameters are correctly programmed, and identify whether the arrhythmia trigger needs further investigation/treatment. This applies even if the shock was clinically appropriate. Device interrogation is a mandatory post-event action.

Reference: Association of Anaesthetists – 2023 – CIEDs perioperative management; RCOA – 2023 – Equipment safety