Effect of electrical cardioversion on myocardial cells in patients in intensive care

BMJ 1998; 316 doi: (Published 18 April 1998) Cite this as: BMJ 1998;316:1207
  1. G Neumayr, doctor,
  2. P Schratzberger, doctor,
  3. G Friedrich, doctor,
  4. H Gänzer, doctor,
  5. C J Wiedermann, doctor
  1. Medical and Intensive Care Unit, Department of Internal Medicine, University of Innsbruck, A-6020 Innsbruck, Austria
  1. Correspondence to: Dr Neumayr
  • Accepted 27 November 1997

For about 30 years electrical cardioversion has been routine for converting arrhythmias.1 Whether the application of shocks in the usual dosage is safe is still controversial as minimal myocardial cell injury cannot be excluded.2 If simultaneous muscle damage occurs the measurement of common cardiac markers, especially creatine kinase and its isoenzyme creatine kinase MB, lacks specificity. We therefore also measured the concentration of cardiac troponin T as this is the most sensitive and specific marker to date.

Patients, methods, and results

Over the past three years in this unit 69 non-selected patients with atrial fibrillation (aged 21-87, mean 63.7 years) underwent elective countershock using a direct current. Serum samples were taken before and 24 hours after cardioversion. The concentrations of cardiac troponin T, …

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