Incidence of myopotential induction in subcutaneous implantable cardioverter-defibrillator patients: Is the oversensing issue really solved?

A novel screening test for inappropriate shocks due to myopotentials from the subcutaneous implantable cardioverter–defibrillator

“…van den Bruck et al 15 recently reported that myopotentials were induced during exercise in >90% of patients. In their study, exercise consisted of isometric chest press, lifting and holding a 20-kg weight, and side plank exercise.…”

The importance of leadless pacemaker positioning in relation to subcutaneous implantable cardioverter-defibrillator sensing in completely leadless cardiac resynchronization and defibrillation systems

“… 11 Oversensing of extracardiac myopotentials is a less common cause of inappropriate shocks, and is usually inducible during exercise. 12 Patient education and exercise S-ICD screening may theoretically reduce this risk, though the latter has not been shown to reduce the incidence of inappropriate shocks. 13 In our case, the myopotential oversensing was due to a fall in paced QRS amplitude, resulting in an automatic increase in the S-ICD sensitivity.…”

Over- and undersensing—pitfalls of arrhythmia detection with implantable devices and wearables

“…Inappropriate shocks may also be triggered by oversensing of low-amplitude signals related to myopotentials during exercise [ 1 ]. A systematic evaluation of consecutive S‑ICD patients for myopotential inducibility in 2019 found that exercise such as isometric chest press, weight-lifting and side plank exercise could all induce myopotentials which led to undersensing in up to 66% and oversensing in up to 22% of patients [ 11 ]. S‑ICD lead and generator position did not appear to affect the induction of myopotentials.…”