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ST-segment elevation with elective DC cardioversion
Circulation
|January 1, 1981
Insights
Direct-current cardioversion for atrial fibrillation can cause temporary ST-segment elevation. Tests confirmed no cardiac damage, but caution is advised due to potential risks.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial fibrillation is a common arrhythmia requiring treatment.
- Direct-current cardioversion is a standard procedure for restoring normal heart rhythm.
Observation:
- Transient ST-segment elevation was observed in monitored leads immediately after cardioversion in three patients.
- This ST-segment elevation lasted only for a few seconds in all recorded instances.
Findings:
- Cardiac enzyme tests (LDH, CPK isoenzymes) and myocardial scintigraphy showed no evidence of myocardial infarction or damage.
- The observed ST-segment changes were not indicative of acute cardiac injury.
Implications:
- While cardioversion is generally safe, transient ST-segment elevation warrants careful monitoring.
- Clinicians should exercise caution during elective cardioversion, acknowledging the potential, albeit unproven in this case, for cardiac complications.
Abstract:
Elective direct-current cardioversion was performed in three patients with atrial fibrillation. Transient ST-segment elevation on monitored leads, lasting seconds, was recorded after cardioversion in all three patients. LDH, CPK isoenzymes, and myocardial scintigraphy did not reveal myocardial damage. Elective cardioversion should be performed with caution, for the potential for cardiac damage cannot be ignored.