High incidence of diaphragmatic myopotential oversensing by a specific implantable cardioverter defibrillator.

Baldinger, Samuel H; Häberlin, Andreas; Servatius, Helge; Seiler, Jens; Noti, Fabian; Lam, Anna; Sweda, Romy; Reichlin, Tobias Roman; Tanner, Hildegard; Roten, Laurent (2020). High incidence of diaphragmatic myopotential oversensing by a specific implantable cardioverter defibrillator. Pacing and clinical electrophysiology, 43(2), pp. 234-239. Wiley 10.1111/pace.13864

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INTRODUCTION Diaphragmatic myopotential oversensing (dMPO) by implantable cardioverter defibrillators (ICDs) is thought to be a rare condition that can be misdiagnosed as lead failure and lead to unnecessary lead replacement. We observed several cases of dMPO in patients with Sorin/LivaNova ICDs (MicroPort Sci.). We sought to systematically assess the incidence of dMPO in patients with Sorin/LivaNova ICDs. METHODS AND RESULTS A predefined number of 100 consecutive patients with Sorin/LivaNova ICDs were prospectively included in the device clinic of our center. Stored arrhythmia episodes were checked for spontaneous dMPO. In addition, we performed provocation maneuvers by Valsalva. At least one episode of spontaneous or provoked dMPO was seen in 12 (12%) of the 100 patients included in the study (86% males, median age: 66 years). Nine of 89 patients (10%) with true bipolar and 3 of 11 patients (27%) with integrated bipolar sensing configuration were affected. Spontaneous dMPO was observed in 7 of 58 patients (12%) with sensitivity programmed to 0.4 mV and in 2 of 42 patients (5%) with sensitivity programmed to 0.6 mV (not significant). In three patients, dMPO could be provoked with no spontaneous episodes recorded. In two nonpacemaker-dependent patients with a CRT-D, ventricular pacing was temporarily inhibited. No antitachycardia therapy was triggered by dMPO in any patient. CONCLUSIONS DMPO is frequent in patients with Sorin/LivaNova ICDs, especially with sensitivity programmed to 0.4 mV. It also frequently occurs with true bipolar sensing configuration. DMPO should not be misinterpreted as lead failure to avoid unnecessary lead replacement.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Baldinger, Samuel H; Häberlin, Andreas; Servatius, Helge Simon; Seiler, Jens; Noti, Fabian; Sweda, Romy; Reichlin, Tobias Roman; Tanner, Hildegard and Roten, Laurent

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1540-8159

Publisher:

Wiley

Language:

English

Submitter:

Andreas Häberlin

Date Deposited:

23 Jan 2020 16:41

Last Modified:

16 Feb 2020 01:36

Publisher DOI:

10.1111/pace.13864

PubMed ID:

31849077

Uncontrolled Keywords:

complications implantable cardioverter defibrillator myopotentials troubleshooting ventricular oversensing

BORIS DOI:

10.7892/boris.137881

URI:

https://boris.unibe.ch/id/eprint/137881

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