Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Article types Case report
Language English
Peer review Peer reviewed
Title Surface electromyography of myopotential oversensing provoked by simultaneous straining and leftward twisting in a patient with an implantable cardioverter defibrillator.
Journal Formal name:Heart and Vessels
Abbreviation:Heart Vessels
ISSN code:0910-8327/1615-2573
Domestic / ForeginDomestic
Publisher Springer Japan
Volume, Issue, Page 32(3),pp.364-368
Author and coauthor AJIRO Yoichi†*, SHIGA Tsuyoshi, SHODA Morio, HAGIWARA Nobuhisa
Publication date 2017/03
Summary An important step in diagnosing myopotential oversensing is to confirm its reproducibility using specific provocation maneuvers. Although most maneuvers involve the co-contraction of many muscles, no attempt has been made to assess relevant muscle activities by electromyography. We describe a case with an implantable cardioverter defibrillator (ICD) whose myopotential oversensing was provoked by simultaneous straining and leftward twisting. Simultaneous recordings from real-time ICD telemetry and myopotentials of the rectus abdominis, oblique abdominis, and diaphragm on electromyography during the provocation maneuvers were conducted. It was shown that all three muscles contracted simultaneously during the provocation maneuvers; the diaphragm activity was the main source of noise oversensing, and the twist itself caused oversensing possibly due to the change in the position of the lead. In conclusion, the electromyographic assessment of relevant muscle activities may be useful in assessing each muscle's role and its contribution to myopotential oversensing, especially in a patient whose myopotential oversensing requires complex maneuvers to be provoked.
DOI 10.1007/s00380-016-0888-9
PMID 27576324