Rhabdomyolysis and Myoglobinuric Renal Failure following Cardioversion and CPR for Acute MI

Severe Hypokalemia and Thyrotoxic Paralysis from Painless Thyroiditis Complicated by Life-threatening Polymorphic Ventricular Tachycardia and Rhabdomyolysis

“…In the present case, severe hypokalemia could have been the cause of rhabdomyolysis; however there is a good possibility that it was the result of resuscitation and defibrillations, which can also increase CPK and LDH. The release of CPK after elective cardioversion correlates with the cumulative energy delivered, thus indicating increased skeletal muscle damage with greater energy (12)(13)(14). Prolonged resuscitative efforts involving repeated defibrillations may predispose patients to rhabdomyolysis.…”

Reversible Myoglobinuric Renal Failure Following Rhabdomyolysis as a Rare Complication of Cardioversion

“…The levels of CK have been reported to be more reliable than myoglobin in the diagnosis of rhabdomyolysis 3 . Furthermore, scan with 99m Tc pyrophosphate can be used to identify the extent of muscle injury caused by multiple DC shocks 5 . In addition, early and rapid increases in creatinine, phosphate, urate, muscle enzymes, and decreases in calcium combined with oliguria or anuria are observed.…”

“…3 Furthermore, scan with 99m Tc pyrophosphate can be used to identify the extent of muscle injury caused by multiple DC shocks. 5 In addition, early and rapid increases in creatinine, phosphate, urate, muscle enzymes, and decreases in calcium combined with oliguria or anuria are observed. In the present case, diagnosis of myoglobinuric renal failure following repeated electrical countershocks has been based on rhabdomyolysis with a 200-fold increase of CK level accompanied by a rapid rise of muscle enzymes, most marked uptake at the site of cardioversion in 99m Tc pyrophosphate scan and development of oliguric, anuric, and diuretic phases of renal failure without prolonged hypotensive period.…”

Rhabdomyolysis Induced by Repeated Internal Cardioverter Defibrillator Discharges

“…Cardioversion, defibrillation, and cardiopulmonary resuscitation may cause elevation of markers of myocardial injury, like creatine kinase (CK), myocardial bound CK (CKMB), cardiac troponin, and myoglobin. [1][2][3][4] Internal defibrillation is a relatively new form of antiarrhythmic therapy that uses low levels of energy and would not be expected to be associated with a substantial rise in markers of myocardial damage after defibrillation. This report describes a patient who developed myoglobinemia and deterioration in renal function following repeated internal defibrillation.…”