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[Myocardial damage caused by electrical cardioversion].

J Sagristá Sauleda1, A Alvarez Auñón, E Larrouse Pérez

  • 1Servicio de Cardiología, Hospital General Vall d'Hebron, Barcelona.

Medicina Clinica
|October 27, 1990
PubMed
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Electrical cardioversion for supraventricular arrhythmias may cause myocardial injury. Higher energy levels (600 joules) showed a greater incidence of cardiac enzyme elevation compared to lower energy levels (200 joules).

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Electrical cardioversion is a common treatment for supraventricular arrhythmias.
  • The potential for myocardial injury following electrical cardioversion requires careful evaluation.

Purpose of the Study:

  • To analyze the incidence of myocardial injury after electrical cardioversion for supraventricular arrhythmias.
  • To compare the effects of different energy levels (200 joules vs. 600 joules) on myocardial injury markers.

Main Methods:

  • Serial measurements of creatine kinase (CK), CK-myocardial band (CK-Mb), and myoglobin were performed.
  • Cardiac gammagraphy using technetium pyrophosphate was conducted in 48 patients.

Main Results:

  • Significant increases in total CK and myoglobin were observed in 4% of patients treated with 200 joules and 50% of patients treated with 600 joules.

Related Experiment Videos

  • CK-Mb elevations occurred in one patient at 200 joules and one patient at 600 joules.
  • Technetium gammagraphy results were negative in all patients, indicating no significant myocardial damage.

    • Conclusions:

    • Electrical cardioversion, particularly at higher energy levels, can lead to transient myocardial injury.
    • Cardiac enzyme monitoring is crucial for assessing myocardial injury after cardioversion.
    • Technetium pyrophosphate scintigraphy may not be sensitive enough to detect minor myocardial changes induced by cardioversion.