Universität zu Köln

van den Bruck, Jan-Hendrik, Sultan, Arian, Plenge, Tobias, Seuthe, Katharina, Moedder, Tim, Iliadis, Christos, Stern, Daniel, Blankenheim, Tatjana, Steven, Daniel and Lueker, Jakob (2019). Incidence of myopotential induction in subcutaneous implantable cardioverter-defibrillator patients: Is the oversensing issue really solved? Heart Rhythm, 16 (10). S. 1523 - 1531. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1556-3871

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Abstract

BACKGROUND The subcutaneous implantable cardioverterdefibrillator (S-ICD) has established its role in the prevention of sudden cardiac death in a defined population. Inappropriate shocks and device malfunction in S-ICD therapy may be caused by myopotential (MP) oversensing. OBJECTIVE The purpose of this study was to systematically evaluate a cohort of consecutive S-ICD patients for MP inducibility. METHODS After S-ICD implantation, all vectors (primary [PrimV], secondary [SecV], alternative [AltV]) were analyzed during isometric chest press (ICP), lifting and holding a 20-kg weight, and side plank exercise (SPE), supporting the body weight on the left arm. When MPs were induced, signal classification was assessed: adequate noise detection, induced undersensing (R waves classified as noise), and oversensing (noise annotated as R waves). In case of noise induction in the current vector, device reprogramming to a noise-free vector was done. RESULTS We systematically assessed 41 patients. In nearly all patients (90.2%), MPs were inducible. ICP was the most potent inductor of MPs. Whereas SecV (70.7%) and AltV (75.6%) were most vulnerable during ICP, PrimV was most affected during SPE (51.2%). In only a few cases did the S-ICD software distinguish correctly between MPs and QRS. MPs predominantly led to undersensing (up to 65.9%), but in up to 22% of patients MP-induced oversensing occurred but did not lead to tachycardia detection. No relation was seen between S-ICD lead and generator position and MP inducibility. CONCLUSION Induction of MPs during physical exercise was observed frequently. Although in most cases MP noise led to undersensing, oversensing events were commonly observed.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code van den Bruck, Jan-Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Sultan, Arian UNSPECIFIED UNSPECIFIED UNSPECIFIED Plenge, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Seuthe, Katharina UNSPECIFIED UNSPECIFIED UNSPECIFIED Moedder, Tim UNSPECIFIED UNSPECIFIED UNSPECIFIED Iliadis, Christos UNSPECIFIED UNSPECIFIED UNSPECIFIED Stern, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Blankenheim, Tatjana UNSPECIFIED UNSPECIFIED UNSPECIFIED Steven, Daniel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueker, Jakob UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-133008
DOI:	10.1016/j.hrthm.2019.04.044
Journal or Publication Title:	Heart Rhythm
Volume:	16
Number:	10
Page Range:	S. 1523 - 1531
Date:	2019
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1556-3871
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INAPPROPRIATE SHOCKS; ICD; EFFICACY; SAFETY; COMPLICATIONS; INTERFERENCE; PREDICTORS; OUTCOMES Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13300