Time course of troponin I, myoglobin, and cardiac enzyme release after electrical cardioversion

Georges, Jean-Louis; Spentchian, Marc; Caubel, Christine; Collignon, Isabelle; Schwob, J.; Livarek, B.; Normand, J

doi:10.1016/s0002-9149(96)00430-4

Cited by 41 publications

(25 citation statements)

References 4 publications

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“…In previous studies, CPK and CK-MB elevations were found in a large proportion of patients after external ECV, ranging from 9.3% to 50% 19 . Due to the lack of biological specifi city of these markers, no conclusion could be reached about what may have caused the release of these enzymes.…”

Section: Ck-mb Massmentioning

confidence: 83%

Cardioversão elétrica e lesão miocárdica: avaliação pelos novos marcadores de injúria cardíaca

Santos

Pereira

Minuzzo

et al. 2006

Arq. Bras. Cardiol.

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OBJECTIVEEvaluate, based on the evolution of new biochemical markers of cardiac damage, if electrical cardioversion (ECV) causes myocardial injury. METHODSSeventy-six patients (P) submitted to elective ECV for atrial fi brillation or atrial fl utter were evaluated. Creatine phosphokinase (CPK), CK-MB activity, CK-MB mass, myoglobin and cardiac troponin I (cTnI) were measured before, and 6 and 24 hours after ECV. RESULTSECV was successful in 58 P (76.3%). Cumulative energy (CE) was up to 350 joules (J) in 36 P, from 500 to 650 J in 20 P and from 900 to 960 J in 20 P; the mean energy delivered being 493 J (± 309). The levels of cTnI remained within normal limits in all 76 P. The increase of cumulative energy led to an elevation of CPK levels (> p value = 0.007), CK-MB activity (> p value = 0.002), CK-MB mass (> p value = 0.03), and myoglobin (> p value = 0.015). A positive correlation between the cumulative energy and CPK peaks was observed (r = 0.660; p < 0.001), CK-MB activity (r = 0.429; p < 0.0001), CK-MB mass (r = 0.265; p = 0.02), and myoglobin (r = 0.684; p < 0.0001), as well as between the number of shocks and the CPK peaks (r = 0.770; p < 0.001), CK-MB activity (r = 0.642; p < 0.0001), CK-MB mass (r = 0.430; p < 0,0001), and myoglobin (r = 0.745; p < 0.0001). CONCLUSIONECV does not cause myocardial injury detectable by cTnI measurement. Elevations of CPK, CK-MB activity, CK-MB mass and myoglobin result from skeletal muscle injury and are positively correlated with the CE delivered or with the number of shocks. KEY WORDSCardioversion, myocardial injury, cardiac troponin I.

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Section: Ck-mb Massmentioning

confidence: 83%

Cardioversão elétrica e lesão miocárdica: avaliação pelos novos marcadores de injúria cardíaca

Santos

Pereira

Minuzzo

et al. 2006

Arq. Bras. Cardiol.

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“…Joglar et al 21 observed cumulative energy levels of 615±385J in the 100J group, 620±694J in 200J group, and 414±176J in 360J group, with significant differences between 100 and 360J groups (p=0.04), and a tendency toward in differences between the 100 and 200J groups (p=0.07), and no differences between the 100 and 200J groups. Unlike high-energy shocks used during cardiopulmonary resuscitation, recent studies [21][22][23][24] report that myocardium damage during electrical cardioversion of atrial fibrillation is minimal or absent.…”

Section: Discussionmentioning

confidence: 99%

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

Figueiredo¹,

Veloso²,

Paola³

2002

Arq. Bras. Cardiol.

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“…9,16 Cardiac troponin I was analyzed immediately after the sample was taken using a 1-step immunoenzymometric assay (Access Immunoassay System TpnI 33320, Beckman Coulter, Inc., Fullerton, Calif., USA). Detection limit for this assay is < 0.15 mcrg/l in healthy donors.…”

Section: Cardiac Troponin Imentioning

confidence: 99%

“…Recently, several workers have reported the detection of a mildly elevated level of cTnI or transient ST-segment elevation in some patients after elective EEC for AF, implying myocardial injury could have been caused by this procedure. [4][5][6][7][8] Other studies showed no change in serum levels of either troponin I or T. 1,[9][10][11][12][13][14] To our knowledge there has not been any study of sufficiently large size addressing the effects of EEC and myocardial damage. Moreover, most of the troponin studies have included clinically unstable patients with raised levels of the biochemical markers, and only a small proportion of patients with reduced ejection fraction (EF) was studied.…”

Section: Introductionmentioning

confidence: 99%

Serum troponin I level after external electrical direct current synchronized cardioversion in patients with normal or reduced ejection fraction: No evidence of myocytes injury

et al. 2005

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SummaryBackground: External electrical cardioversion (EEC) has been suggested as a cause of myocardial damage, but results from several previously published studies are conflicting.Hypothesis: The purpose of the study was to evaluate myocardial electrical injury caused by EEC.Methods: After elective EEC for atrial fibrillation (AF), cardiac troponin I (cTnI) was measured in 193 consecutive patients attending the Cardiology Department of the San Maurizio Hospital of Bolzano for elective EEC of AF over a period of 13 months. External electrical cardioversion was performed by one of the attending cardiologists with a synchronized monophasic defibrillator. Blood sample for cTnI was taken 18-20 h after EEC.Results: Of 193 patients, 183 (95%) were successfully cardioverted. Mean number of shocks was 1.46 and the mean total energy discharged per procedure was 379.4 ± 229.2 J. Cardiac troponin remained under the limit of confidence for all patients with a mean value of 0.017 ± 0.021 mcrg/l. No correlation between total energy delivered and cTnI was found. In the subgroup of patients with low ejection fraction, none had elevated cTnI, and no difference in cTnI values between these and patients with an ejection fraction > 40% was found.

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Time course of troponin I, myoglobin, and cardiac enzyme release after electrical cardioversion

Cited by 41 publications

References 4 publications

Cardioversão elétrica e lesão miocárdica: avaliação pelos novos marcadores de injúria cardíaca

Cardioversão elétrica e lesão miocárdica: avaliação pelos novos marcadores de injúria cardíaca

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

Serum troponin I level after external electrical direct current synchronized cardioversion in patients with normal or reduced ejection fraction: No evidence of myocytes injury

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