Diaphragmatic Myopotentials

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Contents 1 Introduction 2 Workup of Suspected Diaphragmatic Myopotentials 3 Image of Diaphragmatic Myopotentials 4 References

Introduction

Oversensing of Extracardiac Myopotentials^[1] is a well known problem in pacemakers that has been overcome with the use of bipolar sensing leads. Oversensing of diaphragmatic myopotentials(DMP) signals can occur in ICDs and is usually associated with the use of an integrated bipolar lead. Episodes are often seen when during bradycardia in the patient with a intrinsic heart rhythm or in pacemaker dependent patient during pacing.

Workup of Suspected Diaphragmatic Myopotentials

1. Exclude lead failure by measurement of lead related parameters and analysis of stored electrograms
2. Perform Provocation maneuvers
   1. Forced inspiration
   2. Valsalva
3. Programming the sensitivity is sometimes a safe and effective way to prevent DMP oversensing
4. If some cases a surgical revision will need to be performed and you should use a dedicated bipolar lead

Image of Diaphragmatic Myopotentials

References

1. ↑ Journal of Interventional Cardiac Electrophysiology 5, 487–493, 2001. Inappropriate Arrhythmia Detection in Implantable Defibrillator Therapy due to Oversensing of Diaphragmatic Myopotentials