Combined Use of a True‐Bipolar Sensing Implantable Cardioverter Defibrillator in a Patient Having a Prior Implantable Spinal Cord Stimulator for Intractable Pain

Abstract
Reported is a case involving a patient with a previously implanted spinal cord stimulator (SCS) who presented for an implantable. Cardioverter defibrillator (ICD). The SCS device was located in the left lower abdominal quadrant with a stimulation electrode array placed on the dorsal aspect of the spinal cord at the T‐11 thoracic level. Interaction testing demonstrated that the bipolar sensing transvenous ICD system (Medtronic 7221Cx PCD) did not detect 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 mV and the stimulator 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.