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Electrical injury causing ventricular arrhythmias.

P J Jensen, P E Thomsen, J P Bagger

    British Heart Journal
    |March 1, 1987
    PubMed
    Summary
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    Electrical injuries passing through the thorax can cause severe, delayed ventricular arrhythmias. Monitoring patients for at least 24 hours is crucial for early detection and management of these cardiac events.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Toxicology

    Background:

    • Electrical injuries, particularly those involving current passage through the thorax, pose a significant risk for cardiac complications.
    • Ventricular arrhythmias are a known but often delayed consequence of significant electrical trauma.

    Observation:

    • Three patients developed severe, long-lasting ventricular arrhythmias 8-12 hours after thoracic electrical injury.
    • Arrhythmias included ventricular tachycardia, ventricular fibrillation, and ventricular parasystole.
    • Endomyocardial biopsies revealed focal myocardial fibrosis and increased Na, K-pumps, without enzymatic evidence of necrosis.

    Findings:

    • Delayed onset of severe ventricular arrhythmias following thoracic electrical injury.
    • Histopathological changes in the myocardium, including fibrosis and altered ion pump expression, were observed.

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  • Successful management achieved with antiarrhythmic treatment or spontaneous resolution.

    • Implications:

    • Electrocardiographic monitoring for at least 24 hours is recommended for patients with thoracic electrical injuries.
    • Clinicians should inquire about prior electrical injury in patients presenting with unexplained arrhythmias.
    • Understanding the pathophysiology of delayed arrhythmias is critical for patient care and risk stratification.