Implantable cardioverter defibrillator shock: What is the trigger?

Abstract

A 48 year old male with a history of coronary artery disease, hypertension, ischemic cardiomyopathy with an ejection fraction of 10% with an biventricular ICD presented with an shock from his device. He has had increased social stressors at home which have resulted in him running out of his heart failure medications. Investigations are conducted into the reasons for the shock.