Incidence, Risk Factors and Predictors of Phantom Shocks in Patients with Implantable Cardioverter Defibrillators: State-of-the-art Review

Background: Extensive research has been devoted to ICDs, but there is still a significant gap in the literature regarding phantom shocks (PSs). Understanding the frequency, predictors, risk factors, management and health implications of PSs is essential. This review aimed to comprehensively investigate PSs in patients with ICDs up to the present day. Specifically, the review explores the incidence of PSs, identifies risk factors that may increase their likelihood and determines predictive factors to help anticipate their occurrence. By addressing these points, the study aimed to enhance the understanding and management of PSs in ICD patients. Methods: This study reviewed central databases from their inception up to March 2024. The primary objective was to examine the occurrence of PSs in patients with ICDs. Data were gathered on patient demographics, incidence rates, and various risk factors and predictors that might affect the occurrence of PSs. Then, a detailed analysis of the collected data was conducted to identify significant associations between these risk factors, predictors and the incidence of PSs. Results: This review identified a significant association between prior ICD shocks, defibrillation threshold testing, the presence of depression and anxiety for the occurrence of PS in patients with ICDs. This underscores the importance of thoroughly evaluating and managing these factors to improve the care of individuals with ICDs. Conclusion: PSs are often associated with various factors, such as previous shock therapy, defibrillation threshold testing, depression, anxiety and higher levels of education. It is crucial for healthcare providers to acknowledge these correlations and provide personalised care to patients experiencing PSs.