Analysis of Troponin I Levels After Spontaneous Implantable Cardioverter Defibrillator Shocks

Hasdemir, Can; Shah, Nayyar; Rao, Arun; Acosta, Helbert; Matsudaira, Kagari; Neas, Barbara R.; Reynolds, Dwight; Po, Sunny S.; Lazzara, Ralph; Beckman, Karen J.

doi:10.1046/j.1540-8167.2002.00144.x

Cited by 74 publications

(47 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The positive and negative predictive values of an elevated troponin level were 21% and 94%, making troponin testing a valuable tool in excluding significant myocardial injury after trauma. Other reasons for traumatic troponin elevation include implantable cardioverter defibrillator shocks (28) and infiltrative disorders such as amyloidosis (29). It has been postulated that extracellular amyloid deposition may lead to myocyte compression injury, leading to myocardial damage and troponin release.…”

Section: Direct Myocardial Damagementioning

confidence: 99%

Narrative Review: Alternative Causes for Elevated Cardiac Troponin Levels when Acute Coronary Syndromes Are Excluded

2005

View full text Add to dashboard Cite

Current guidelines for the diagnosis of non-ST-segment elevation myocardial infarction are largely based on an elevated troponin level. While this rapid and sensitive blood test is certainly valuable in the appropriate setting, its widespread use in a variety of clinical scenarios may lead to the detection of troponin elevation in the absence of thrombotic acute coronary syndromes. Many diseases, such as sepsis, hypovolemia, atrial fibrillation, congestive heart failure, pulmonary embolism, myocarditis, myocardial contusion, and renal failure, can be associated with an increase in troponin level. These elevations may arise from various causes other than thrombotic coronary artery occlusion. Given the lack of any supportive data at present, patients with nonthrombotic troponin elevation should not be treated with antithrombotic and antiplatelet agents. Rather, the underlying cause of the troponin elevation should be targeted. However, troponin elevation in the absence of thrombotic acute coronary syndromes still retains prognostic value. Thus, cardiac troponin elevations are common in numerous disease states and do not necessarily indicate the presence of a thrombotic acute coronary syndrome. While troponin is a sensitive biomarker to "rule out" non-ST-segment elevation myocardial infarction, it is less useful to "rule in" this event because it may lack specificity for acute coronary syndromes. Ann Intern Med. 2005;142:786-791. www.annals.org For author affiliations, see end of text.

show abstract

Section: Direct Myocardial Damagementioning

confidence: 99%

Narrative Review: Alternative Causes for Elevated Cardiac Troponin Levels when Acute Coronary Syndromes Are Excluded

2005

View full text Add to dashboard Cite

show abstract

“…9) The cause of increased risk may be postulated that the negative inotropic consequences of the shock itself could increase the risk of death, especially when the patient receives multiple shocks due to oversensing or in response to ongoing supraventricular tachycardia. [10][11][12][13] Thus, effective strategies to reduce ICD shocks are desirable. Antiarrhythmic medication is frequently administered in patients with an ICD.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Additional Amiodarone Therapy in Patients with an Implantable Cardioverter‐Defibrillator

Matsumoto

Kumagai

Ogawa

et al. 2010

Journal of Arrhythmia

View full text Add to dashboard Cite

Introduction: We examined whether the additional use of amiodarone (AMD) under implantable cardioverter-defibrillator (ICD) therapy may have beneficial effects in patients at risk for lethal ventricular arrhythmias with structural heart diseases.Methods: Sixty patients (47 males, mean age, 62 AE 13 years) with structural heart disease who underwent ICD implantation were retrospectively analyzed. There were 2 groups: one group (AMD group) was treated with AMD (n ¼ 33) and the other group (non-AMD group) was treated without AMD (n ¼ 27). We compared the incidence and appropriateness of ICD shock therapy between two groups.Results: During a mean follow-up of 28 AE 17 months, we identified a total of 62 episodes in 18 patients (30%) who received ICD shock therapy. ICD shock episodes were significantly less frequent in AMD group than in non-AMD group (15% versus 48%, P < 0:01), while inappropriate shock episodes were greater in non-AMD group than in AMD group (49% versus 4%, P ¼ 0:03). In cumulative probability of shock events, the risk of events was significantly lower in AMD group (P ¼ 0:007). Of 4 patients who died in AMD group, we observed one fatal pulmonary fibrosis.Conclusions: Additional AMD therapy in patients with an ICD may be effective in reducing the risk of shock discharge. (J Arrhythmia 2010; 26: 103-110)

show abstract

“…Finally, in animal experiments and human studies, it has been shown that the voltage gradients in the heart are lower during S-ICD defibrillation as compared to transvenous ICD defibrillation; S-ICD defibrillation is also not associated with troponin release. (13)(14)(15)(16) Nevertheless, the S-ICD system is not without its disadvantages. When compared to transvenous ICD systems, S-ICD systems can only provide backup pacing following a shock, as pacing from the subcutaneous position invariably causes painful muscle stimulation.…”

Section: A 4bmentioning

confidence: 99%

“…Therefore, S-ICD systems cannot provide antitachycardia pacing to painlessly terminate VT. In addition, as the energy needed by the S-ICD system to defibrillate is approximately three-fold higher than that needed by transvenous ICD systems, (13,14) the pulse generator of the S-ICD system is more bulky than the current generation of transvenous ICD systems. (17,18) It measures 78 mm × 65 mm × 15 mm, with a volume of 69 cc and a mass of 145 g, which is almost twice the size of a traditional ICD.…”

Section: A 4bmentioning

confidence: 99%

Initial experience of subcutaneous implantable cardioverter defibrillators in Singapore: a case series and review of the literature

Lim

Tan

et al. 2015

smedj

View full text Add to dashboard Cite

Transvenous implantable cardioverter defibrillators are a type of implantable cardiac device. They are effective at reducing total and arrhythmic mortality in patients at risk of sudden cardiac death. Subcutaneous implantable cardioverter defibrillators (S-ICDs) are a new alternative that avoids the disadvantages of transvenous lead placement. In this case series, we report on the initial feasibility and safety of S-ICD implantation in Singapore.

show abstract

Analysis of Troponin I Levels After Spontaneous Implantable Cardioverter Defibrillator Shocks

Abstract: Serum cTnI rises occur in the majority of patients after multiple (>3) spontaneous ICD discharges but are due to acute coronary syndrome only 14% of the time (22% of the time in patients with known coronary artery disease).

Cited by 74 publications

References 4 publications

Narrative Review: Alternative Causes for Elevated Cardiac Troponin Levels when Acute Coronary Syndromes Are Excluded

Narrative Review: Alternative Causes for Elevated Cardiac Troponin Levels when Acute Coronary Syndromes Are Excluded

Efficacy of Additional Amiodarone Therapy in Patients with an Implantable Cardioverter‐Defibrillator

Initial experience of subcutaneous implantable cardioverter defibrillators in Singapore: a case series and review of the literature

Contact Info

Product

Resources

About