Cardiac troponin I and cardiac enzymes after electrophysiologic studies, ablations, and defibrillator implantations

Rao, Surya P.; Miller, Scott; Rosenbaum, R.M.; Lakier, Jeffrey B.

doi:10.1016/s0002-9149(99)00337-9

Cited by 20 publications

(19 citation statements)

References 7 publications

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“…The present study confirms previous investigations [15][16][17][18][19][20] that cTnT, MG, and CKMB mass are more accurate markers for the assessment of myocardial damage than total CK and CKMB activity. Table IV summarizes the available literature on biochemical markers of myocardial injury after ablation therapy.…”

Section: Discussionsupporting

confidence: 92%

“…Several biochemical parameters have been validated in the diagnosis of this myocardial damage induced by RF ablation. [14][15][16][17][18][19][20] It has been shown that cardiac troponin I and T are more sensitive and more specific than creatine kinase, myocardial bound (CKMB) for the diagnosis of minor myocardial injury. 21 This has been demonstrated first in acute coronary syndrome 22, 23 and confirmed by several authors for RF ablation.…”

mentioning

confidence: 99%

“…21 This has been demonstrated first in acute coronary syndrome 22, 23 and confirmed by several authors for RF ablation. [14][15][16][17][18][19][20] The extent of injury appears to depend on the number of RF lesions, the site of ablation, and the approach to the mitral CARLSSON, J., ET AL. : Myocardial Injury During Radiofrequency Catheter Ablation: Comparison of Focal and Linear Lesions.…”

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confidence: 99%

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Myocardial Injury During Radiofrequency Catheter Ablation: Comparison of Focal and Linear Lesions

Carlsson¹,

Erdoğan²,

Guettler³

et al. 2001

Pacing Clinical Electrophis

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The aim of study was to investigate the extent of myocardial injury incurred by creation of continuous RF current induced linear ablation lesions (LL; ablation of atrial fibrillation, right atrial procedure) in comparison to focal RF lesions (FL; AV node reentry tachycardia, WPW tachycardia). In 23 patients with LL (age 51.3 +/- 11.2 years, 18 men, 5 women) and in 16 patients with FL (age 53.9 +/- 5.1 years, 8 men and 8 women), levels of creatine kinase (CK), myoglobin (MG), CKMB mass (CKMB M), CKMB activity (CKMB A), and cardiac troponin T (cTnT) were determined before and 2, 4, 8, 24, and 48 hours after ablation. CKMB A was normal in 87% in LL and 100% in FL (< 6% of CK) with median maximum CK values of 214 (45-1583) U/L in LL and 36 (29-212) U/L in FL. Peak values of all parameters were significantly higher in LL than in FL. The sensitivity of cTnT was 50% in FL and 100% in LL. In FL MG, total CK, and CKMB M were abnormal in only 12.5% of cases while in LL MG and CKMB M were pathological in 100% and total CK was abnormal in 91.3% of patients. The amount of energy and number of RF applications correlated with cTnT, MG, and CKMB M (P = 0.01). In conclusion, (1) long linear RF current lesions for ablation of atrial fibrillation are associated with significantly greater myocardial injury than focal ablations. (2) In focal lesions only cTnT provided a sensitivity of 50% in the detection of myocardial injury while in linear lesions cTnT, CKMBM, and CKMB M seemed suitable for detection of RF current induced myocardial damage with 100% sensitivity. All biochemical parameters do not differentiate patients with coronary ischemia up to 48 hours after an ablation. (3) Further investigations are necessary to determine if RF current linear lesions lead to impaired atrial contractility in cases of extensive tissue damage.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

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confidence: 99%

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Myocardial Injury During Radiofrequency Catheter Ablation: Comparison of Focal and Linear Lesions

Carlsson¹,

Erdoğan²,

Guettler³

et al. 2001

Pacing Clinical Electrophis

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“…The cardiac isotype is specific for heart muscle injury. However, it has rarely been [3][4][5][6][7][8][9]. Cardiac troponin I (cTnI) has been shown to be more sensitive and specific than CK-MB and more specific than cardiac troponin T for the diagnosis of minor myocardial injury [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of post-radiofrequency myocardial injury by measuring cardiac troponin I levels

Emkanjoo

Mottadayen

Givtaj

et al. 2007

International Journal of Cardiology

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“…They have the potential to have an enormous impact on novel drug development, providing earlier indications of efficacy or toxicity. This should facilitate early termination, reduce later stage attrition, and shorten overall development times (http://science.thomsonreuters.com/info/biomarkers) [12][13][14][15][16][17]. Table 3.4 lists some established and putative biomarkers, their possibilities and constraints.…”

Section: Biomarkersmentioning

confidence: 99%

Controlling Drug Release in Oral Product Development Programs: An Industrial Perspective

Martini

Crowley

2011

Controlled Release in Oral Drug Delivery

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Most new drugs for oral administration are released rapidly from the dosage form. This may give "peak-trough" plasma profiles not suited to the drug's mode of action or side effect profile. Traditionally, there were few options for better design to optimize rate or time of release. However, advances in many areas of drug evaluation are now identifying opportunities to modify drug release during earlier phases of development to optimize therapeutic efficacy and reduce undesirable effects. It should also result in better success rates in drug development programs as well as better medications for patient treatment.This chapter explores possibilities for modifying release during Preclinical, Phase 1, Phase 2, and Phase 3 programs. Opportunities to improve performance or find new indications for mature drugs, by controlling release continue to emerge. Such possibilities are also considered. The chapter is written, not only for the product design (formulation) specialist but also for scientists involved in all aspects of drug evaluation and development. Consequently, its focus is on the breadth rather than depth of the topic. Other chapters provide more comprehensive accounts of specific approaches, technologies, and modes of evaluation.

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Cardiac troponin I and cardiac enzymes after electrophysiologic studies, ablations, and defibrillator implantations

Cited by 20 publications

References 7 publications

Myocardial Injury During Radiofrequency Catheter Ablation: Comparison of Focal and Linear Lesions

Myocardial Injury During Radiofrequency Catheter Ablation: Comparison of Focal and Linear Lesions

Evaluation of post-radiofrequency myocardial injury by measuring cardiac troponin I levels

Controlling Drug Release in Oral Product Development Programs: An Industrial Perspective

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