title: A fortuitous syncope. The pitfalls of integrated bipolar defibrillator leads.
abstract: Myopotential oversensing in implantable defibrillators causing inhibition of pacing and inappropriate therapies is well described. Current literature is dominated by reports of diaphragmatic muscle as the source of such far-field oversensing. Those reporting pectoral muscle sources were invariably due to unipolar sensing circuits, incorrect DF-1 connections or inappropriate programming. We report an interesting case of pectoral muscle myopotential oversensing causing inhibition of bradycardia pacing leading to presyncope and syncope.
authors.affiliation: Department of Cardiac Electrophysiology, St Mary's Hospital and Imperial College, London, UK. salukhe@aol.com
authors.forename: Tushar V
authors.initials: TV
authors.lastname: Salukhe
authors.forename: Ian
authors.initials: I
authors.lastname: Wright
authors.forename: Matthew
authors.initials: M
authors.lastname: Wright
authors.forename: Prapa
authors.initials: P
authors.lastname: Kanagaratnam
authors.forename: Mark D
authors.initials: MD
authors.lastname: O'Neill