title: Surface electromyography of myopotential oversensing provoked by simultaneous straining and leftward twisting in a patient with an implantable cardioverter defibrillator.
abstract: 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.
authors: Department of Cardiology, National Hospital Organization Yokohama Medical Center, 3-60-2 Harajuku, Totsuka-ku, Yokohama, Kanagawa, 245-8575, Japan. aziro-youichi@yokohamamc.jp.
authors: Yoichi
authors: http://orcid.org/0000-0002-1975-203X
authors: Y
authors: Ajiro
authors: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors: Tsuyoshi
authors: T
authors: Shiga
authors: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors: Morio
authors: M
authors: Shoda
authors: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors: Nobuhisa
authors: N
authors: Hagiwara
mesh_terms: D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D003964:Diaphragm; D004562:Electrocardiography; D004576:Electromyography; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000209:etiology*
keywords: Abdominal muscles; Diaphragm; Implantable cardioverter defibrillator; Myopotential oversensing; Surface electromyography