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Diaphragmatic myopotential oversensing in pacemaker-dependent patients with CRT-D devices

2008; Oxford University Press; Volume: 10; Issue: 12 Linguagem: Inglês

10.1093/europace/eun241

1532-2092

Kelly Rodrigues dos Santos, Pedro Adragão, Diogo Cavaco, Francisco Bello Morgado, Rui Candeias, S. Lima, José Antônio Silva,

Cardiovascular Function and Risk Factors

To evaluate the incidence and clinical significance of diaphragmatic myopotential (dMP) oversensing in pacemaker (PM)-dependent patients with CRT-Ds.We retrospectively evaluated patients with CRT-Ds implanted at our institution between January 2000 and August 2006. PM-dependent patients were identified, and the incidence of inappropriate detections due to dMP oversensing and their possible clinical implications (inappropriate therapies, syncope, and death of any cause) were evaluated. CRT-Ds were implanted in 122 patients, 37 were or became PM dependent. During a mean follow-up of 22 +/- 17 months, 7(18.9%) PM-dependent patients revealed inappropriate detections due to dMP oversensing. All oversensing episodes occurred in CRT-Ds with automatic gain control (AGC) sensing and integrated bipolar (IBP) leads in the RV apex. These detections led to inappropriate shocks in 2(5.4%) patients and syncope in 1(2.7%). Five (13.5%) patients died.dMP oversensing in PM-dependent patients with CRT-Ds is an important problem, particularly in CRT-Ds with AGC sensing and IBP leads, with over 20% of patients with these devices revealing inappropriate detections. The clinical impact of dMP oversensing is less marked but relevant, with both inappropriate therapies and syncope occurring in this small group of 37 patients and the possibility of related deaths.