Use of cardiac troponin t rapid assay in the diagnosis of a myocardial injury secondary to electrical cardioversion

Abstract

SummaryBackground and hypothesis: This study was carried out to determine whether cardiac troponin T test in rapid assay gives positive results in patients previously submitted to cardioversion or electrical defibrillation.Methods: Forty patients with supraventricular tachyarrhythmias lasting no more than 2 days were treated with electrical cardioversion. The total creatine phosphokinase (CPK)-MB isoenzyme and troponin T in rapid assay were measured at baseline and at 6,12, and 24 h thereafter.Results: Total CPK baseline levels were normal in all cases; within 4 h, the serum CPK levels increased by 98%, at 6 h

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

“…Previous studies were conducted in a small number of patients, and inclusion/exclusion criteria often were not strict; our results confirm those described in some previous studies. 1,[9][10][11][12][13][14] On the other hand, our findings are discordant with those of other studies involving smaller series of patients, demonstrating the presence of mild myocardial injury in some patients after elective EEC for AF. [4][5][6][7][8] Differences in inclusion criteria may account for the discrepancies in the observed conclusions.…”

“…[1][2][3] Many investigators have studied the effects of cardioversion on the cardiac muscle by measuring serum levels of the biochemical markers reflecting myocardial damage. Cardiac troponin I (cTnI) has been reported to be the most specific and sensitive among conventional markers; however, the effect of EEC on the level of cTnI has not been well established.…”

“…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.…”

It’s Time for a Change to a Troponin Standard

“…Biomarker increases can occur secondary to direct trauma to the heart, 2,3 as a result of myocardial toxins such as adriamycin or 5-fluorouracil, 41 or in response to endogenous substances released in critically ill patients (eg, patients with septic shock). 42,43 Mechanical injury (such as ablation), 44 implantable cardioverter defibrillator discharges, 45 and cardioversion 46 all induce cardiac injury. Furthermore, a variety of transitory abnormalities can cause minor degrees of myocardial injury that may be self-abating.…”

Prognostic Importance of Predischarged Troponin T Levels in Acute Anterior Myocardial Infarction

“…5) With these qualifications, in our study, the values of cTnT in the prediction of LV function have been investigated using a rapid bedside assay. 13,[19][20][21][22][23][24] Quantitative bedside cTnT measurements were preferred because they are rapid and independent from laboratory assessment.…”