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High incidence of diaphragmatic myopotential oversensing by a specific implantable cardioverter defibrillator
Author(s) -
Baldinger Samuel H.,
Haeberlin Andreas,
Servatius Helge,
Seiler Jens,
Noti Fabian,
Lam Anna,
Sweda Romy,
Reichlin Tobias,
Tanner Hildegard,
Roten Laurent
Publication year - 2020
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.13864
Subject(s) - medicine , cardiology , implantable cardioverter defibrillator , incidence (geometry) , diaphragmatic breathing , provocation test , lead (geology) , physics , alternative medicine , pathology , geomorphology , optics , geology
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.