Format

Send to

Choose Destination
Chest. 1997 Jan;111(1):15-8.

Cardiac troponin I does not increase after cardioversion.

Author information

1
Service de Cardiologie, Hôpital Cardiologique et Pneumologie Louis Pradel, Lyon, France.

Abstract

BACKGROUND:

Serum total creatine kinase (total CK) level increases in the patients following electrical cardioversion. The same has been observed with CK-MB, an isoenzyme of the total CK with some cardiospecificity. Cardiac troponin I (cTnI), a new specific cardiac biological marker, is highly effective to discriminate myocardial and muscular injuries after noncardiac surgery.

METHODS:

To assess cardiac damage after cardioversion, we measured serum cTnI, myoglobin, total CK, CK-MB mass, 1, 2, 3, 4, 8, 12, and 24 h after elective cardioversion of supraventricular tachycardia in 28 patients (eight women, 20 men; mean age, 64 +/- 10 years). Cumulative energy was below 370 J in 17 patients, between 370 and 900 J in eight patients, and 1,020 J in three patients. Serum cTnI was measured using a sandwich immunoenzymologic assay. The detection limit of the assay was 0.35 microgram/L and normal values range from 0.35 to 1.3 micrograms/L.

RESULTS:

In all but three patients, cTnI remained below 0.35 microgram/L. In these three patients, cTnI ranged between 0.35 and 0.9 microgram/L. There was no correlation between cTnI and the number or the energy of cardioversion. Myoglobin and total CK increased to abnormal concentrations in 11 patients (myoglobin, 630 +/- 190 micrograms/L, and total CK, 2,584 +/- 780 U/L) and reached myocardial infarction-like values in five patients. Modest increases of CK-MB were then also observed. A strong correlation was observed between the total energy of direct current cardioversion and the increase of either myoglobin (r = 0.87; p < 001) or total CK (r = 0.81; p < 001).

CONCLUSION:

Cardioversion in a clinical setting does not induce elevation of cTnI. Increase in total CK, CK-MB, and myoglobin may be due solely to muscular lesions and is closely related to the cumulative energy delivered.

Comment in

PMID:
8995986
DOI:
10.1378/chest.111.1.15
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center