Serum cardiac markers response to biphasic and monophasic electrical cardioversion for supraventricular tachyarrhythmia : a randomised study

Roman Skulec; Jan Belohlavek; Tomas Kovarnik; Jiri Kolar; Jana Gandalovicova; Vladimir Dytrych; Ales Linhart; Michael Aschermann

doi:10.1016/j.resuscitation.2006.02.003

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Serum cardiac markers response to biphasic and monophasic electrical cardioversion for supraventricular tachyarrhythmia : a randomised study

Journal article

Peer reviewed

Serum cardiac markers response to biphasic and monophasic electrical cardioversion for supraventricular tachyarrhythmia : a randomised study

Roman Skulec, Jan Belohlavek, Tomas Kovarnik, Jiri Kolar, Jana Gandalovicova, Vladimir Dytrych, Ales Linhart and Michael Aschermann

Resuscitation, Vol.70(3), pp.423-431

09/01/2006

DOI: 10.1016/j.resuscitation.2006.02.003

PMID: 16901614

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Abstract

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) > 150 J was associated with significant elevation of CK and myoglobin levels after cardioversion (1.52 ± 3.81 μkat/l and 187 ± 433 μg/l), while CE < 150 J was not (−0.04 ± 0.34 and 4 ± 11, p < 0.05). In BP group, CE > 150 J was associated with significant but smaller CK elevation (0.27 ± 1.09 μkat/l, p < 0.05) and comparable myoglobin elevation (80.7 ± 21.4 μg/l, p < 0.05). CE > 150 J 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 > 150 J 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.

Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy

Biological and medical sciences

Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis

Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care

Intensive care medicine

Medical sciences

Transfusions. Complications. Transfusion reactions. Cell and gene therapy

Details

Title: Subtitle: Serum cardiac markers response to biphasic and monophasic electrical cardioversion for supraventricular tachyarrhythmia : a randomised study
Creators: Roman Skulec - General University Hospital in Prague
Jan Belohlavek - General University Hospital in Prague
Tomas Kovarnik - General University Hospital in Prague
Jiri Kolar - General University Hospital in Prague
Jana Gandalovicova - General University Hospital in Prague
Vladimir Dytrych - General University Hospital in Prague
Ales Linhart - General University Hospital in Prague
Michael Aschermann - General University Hospital in Prague
Resource Type: Journal article
Publication Details: Resuscitation, Vol.70(3), pp.423-431
Publisher: Elsevier
DOI: 10.1016/j.resuscitation.2006.02.003
PMID: 16901614
ISSN: 0300-9572
eISSN: 1873-1570
Language: English
Date published: 09/01/2006
Academic Unit: Electrical and Computer Engineering
Record Identifier: 9984627344302771

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