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High Sensitivity Cardiac Troponin T Levels after Elective Cardioversion for Atrial Fibrillation/Flutter

Zaza Iakobishvili, Adaya Weissler, Kiril Buturlin

    The Israel Medical Association Journal : IMAJ
    |December 16, 2015
    PubMed

    Insights

    High sensitivity cardiac troponin T (hs-cTnT) levels are elevated in persistent atrial fibrillation/flutter patients but do not increase after cardioversion. Post-cardioversion biomarker levels gradually decrease, indicating changes are not due to the procedure.

    Area of Science:

    • Cardiology
    • Biomarker analysis

    Background:

    • Persistent atrial fibrillation/flutter is common.
    • The impact of cardioversion on cardiac biomarkers is not well understood.

    Purpose of the Study:

    • To investigate the kinetics of high sensitivity cardiac troponin T (hs-cTnT) after cardioversion.
    • To assess changes in other cardiac injury and inflammation markers post-cardioversion.

    Main Methods:

    • Studied 24 patients undergoing elective cardioversion for persistent atrial fibrillation/flutter.
    • Measured hs-cTnT, creatine kinase, aspartate aminotransferase, lactate dehydrogenase, brain natriuretic peptide (BNP), and high sensitivity C-reactive protein (hs-CRP) at multiple time points.
    • Analyzed biomarker levels at baseline, 2, 6, 24 hours, 7 days, and 30 days post-cardioversion.

    Main Results:

    • Baseline hs-cTnT levels were elevated in most patients (14/24 above the 99th percentile).
    • Hs-cTnT levels did not significantly increase after cardioversion, showing a non-significant trend towards decrease by 30 days.
    • No significant rise in other myocardial injury markers was observed; BNP and hs-CRP were elevated at baseline and decreased over time.

    Conclusions:

    • Elevated hs-cTnT, BNP, and hs-CRP in atrial fibrillation/flutter patients are not exacerbated by cardioversion.
    • Post-cardioversion biomarker changes are not attributable to the procedure itself.
    • Cardioversion does not appear to cause acute myocardial injury as indicated by hs-cTnT kinetics.
    Abstract

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