Inappropriate ICD shocks due to diaphragmatic myopotential oversensing can be managed by modifying ventricular detection duration and decreasing sensitivity.
Reprogramming may avert myopotential-triggered inappropriate ICD shocks; single case leaves open generalizability and durability.
Two cases are reported (both men, one 72 and one 54 years old) of inappropriate shocks delivered by an implantable cardiac defibrillator (ICD) device, which oversensed the myopotentials induced by deep breathing and Valsalva manoeuvre. No damage to leads was associated with the oversensing of myopotentials. The mechanism of the inappropriate shocks was determined using real time electrograms. Modification of the duration of ventricular detection and decrease in sensitivity made it possible to avoid the oversensing of myopotentials and to deliver ICD treatment.
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Babuty et al. (1999) studied this question.
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