Document Detail

Serum cardiac markers response to biphasic and monophasic electrical cardioversion for supraventricular tachyarrhythmia--a randomised study.
MedLine Citation:
PMID:  16901614     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Electrical cardioversion in patients with various types of supraventricular tachyarrhythmia (SVT) may induce serum cardiac markers elevation. Only a few studies have evaluated the impact of the type of shock waveform on electrical myocardial injury. The aim of our study was to compare the response of serum cardiac markers to biphasic and monophasic cardioversion for SVT. METHODS: One hundred and forty one patients with various SVTs referred for electrical cardioversion were randomised to monophasic (MP) or biphasic (BP) cardioversion. Serum levels of creatine kinase (CK), MB fraction of CK (CK-MB), myoglobin and troponin I were analysed before cardioversion and 254+/-58 min after the procedure. RESULTS: Average age of the patients was 67.9+/-11.3 years, 71 underwent BP and 70 MP cardioversion. In MP group, cumulative energy (CE)>150J was associated with significant elevation of CK and myoglobin levels after cardioversion (1.52+/-3.81 microkat/l and 187+/-433 microg/l), while CE<150J was not (-0.04+/-0.34 and 4+/-11, p<0.05). In BP group, CE>150J was associated with significant but smaller CK elevation (0.27+/-1.09 microkat/l, p<0.05) and comparable myoglobin elevation (80.7+/-21.4 microg/l, p<0.05). CE>150J was the only independent positive predictor for CK and myoglobin elevation in both groups. No significant changes in CK-MB and Troponin I levels after cardioversion were identified. CONCLUSIONS: According to our study, electrical cardioversion for SVTs is not associated with biochemical signs of myocardial injury. Application of CE>150J can be followed by CK and myoglobin elevation most likely due to skeletal muscle damage. This reaction is more pronounced in MP than in BP cardioversion.
Roman Skulec; Jan Belohlavek; Tomas Kovarnik; Jirí Kolar; Jana Gandalovicova; Vladimir Dytrych; Ales Linhart; Michael Aschermann
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2006-08-09
Journal Detail:
Title:  Resuscitation     Volume:  70     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-04     Completed Date:  2007-02-06     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  423-31     Citation Subset:  IM    
2nd Department of Internal Cardiovascular Medicine, General Teaching Hospital, U Nemocnice 2, 128 08 Prague 2, Czech Republic.
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MeSH Terms
Atrial Fibrillation / blood,  metabolism,  therapy
Atrial Flutter / blood,  metabolism,  therapy
Biological Markers / blood*
Electric Countershock / methods*
Tachycardia, Ectopic Atrial / blood,  metabolism,  therapy
Tachycardia, Supraventricular / blood*,  metabolism,  therapy*
Reg. No./Substance:
0/Biological Markers

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