Document Detail


Use of troponin-T concentration and kinase isoforms for quantitation of myocardial injury induced by radiofrequency catheter ablation.
MedLine Citation:
PMID:  9183594     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although there remains particular concern about late malignant ventricular arrhythmias arising from myocardial damage induced by catheter ablation, the extent of myocardial injury resulting from clinical ablation procedures has not been fully studied. We conducted a prospective, controlled study to investigate the use of two newer markers of myocardial integrity, troponin-T concentration and creatine kinase isoforms, and a traditional marker, creatine kinase-MB concentration, in the assessment of myocardial injury following radiofrequency catheter ablation. METHODS AND RESULTS: The study population consisted of 28 consecutive patients subjected to radiofrequency catheter ablation, and the control group comprised eight subjects undergoing diagnostic electrophysiology study. Prior to ablation and at 30 min, 1, 2, 6, and 12 h following the procedure, blood samples were taken to measure troponin-T and creatine kinase-MB concentrations, and the separation of creatine kinase isoforms (MM3/MM1 and MB2/MB1 ratios). The troponin-T concentration was above normal in all but two patients following radiofrequency ablation, and the MB2/MB1 ratio was raised in all but one patient following ablation, but was also abnormal in the pre-ablation samples in seven patients. The MM3/MM1 ratio failed to detect myocardial injury in 75% of patients. Of patients subjected to ablation, in only 36% was the creatine kinase-MB concentration raised at least once post-ablation. Thirty minutes post-ablation, there was a statistically significant difference between the control and patient groups only as regards troponin-T concentration. There was a significant association between troponin-T concentration immediately post-procedure, the number of discharges delivered (r = 0.52, P = 0.006) and maximum power used (r = 0.48, P = 0.009). CONCLUSION: Our results indicate that catheter ablation inflicts a cumulative, detectable injury upon the myocardium. This injury can be quantitated by using newer analytical techniques, such as serial, post-ablation measurements of troponin-T concentration.
Authors:
D Katritsis; M Hossein-Nia; A Anastasakis; I Poloniecki; D W Holt; A J Camm; D E Ward; E Rowland
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  18     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-21     Completed Date:  1997-08-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1007-13     Citation Subset:  IM    
Affiliation:
Department of Cardiological Sciences, St George's Hospital Medical School, London, U.K.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arrhythmias, Cardiac / physiopathology,  surgery*
Biological Markers / blood
Catheter Ablation / adverse effects*
Creatine Kinase / blood,  metabolism*
Female
Humans
Injury Severity Score
Male
Middle Aged
Myocardium / enzymology*,  pathology
Prospective Studies
Sensitivity and Specificity
Troponin / blood,  metabolism*
Troponin T
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin; 0/Troponin T; EC 2.7.3.2/Creatine Kinase

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