Myocardial Injury After Electrical Therapy for Cardiac Arrhythmias Assessed by Troponin-T Release

Survival of Patients With Implantable Cardioverter Defibrillators in the Era of Remote-Monitoring: The 5000-Foot, High-Altitude View

“…However, it is not easy to tease apart cause and effect. Troponin increases after shock, 13 and postshock decreases in left ventricular function have also been reported, 14 suggesting potential detrimental effects of shock on the myocardium. It is possible that shocks, appropriate or inappropriate, are a cause of poor outcome, due to direct adverse effects on the myocardium 13 or activation of adverse signaling pathways as has been postulated.…”

The Implantable Cardioverter-Defibrillator Minimalist

“…Defibrillation-level shock energies cause release of cardiacspecific injury biomarkers that increase with size of electric trauma (shock strength, number of shocks, total joules delivered), transvenous Ͼ transthoracic shocks, recent myocardial infarction, and time in VTA. 35,36 Despite revascularization, implant shocks generated a 10-times higher cardiac biomarker release among patients with recent myocardial infarction. 35 Particularly relevant to DINAMIT and IRIS is evidence that ischemia dramatically enhances the negative effects of shocks on recovery of LV pump function after VF termination.…”

Prognostic Significance of Implantable Cardioverter-Defibrillator Shocks

“…In contrast to the data on ICD shocks, there is no evidence that ATP has adverse cardiac effects. ATP termination of VT or FVT, unlike shocks, does not cause biomarker release 20 or reduce ventricular pump function. 21 …”