Dislodgement of a subcutaneous shock lead owing to loop release in the device pocket in a pediatric patient with congenital long QT syndrome

Implantable cardioverter-defibrillators (ICDs) are increasingly used in pediatric patients for both primary and secondary prevention of sudden cardiac death. In this population, ICD management requires consideration of small body size, growth-related changes, and disease-specific characteristics. In infants and young children, conventional transvenous lead placement for ICD implantation is often challenging because of the small vascular caliber, and alternative strategies—such as positioning shock leads in subcutaneous or epicardial locations—are employed on a case-by-case basis.