Electrical injury and the frequency of cardiac complications

A retrospective review of the patients with electrical injuries admitted over a 5-year period was performed to establish the frequency of cardiac complications. There were 145 admissions during this time. A total of 128 (88 per cent) were low voltage injuries and 17 (12 per cent) were high voltage (> 1000 V) injuries. Of the 145 admissions, 104 (72 per cent) had a 12-lead electrocardiogram (ECG) recorded within 24 h of their injury. Of these patients, 73 (75 per cent) were then observed on a cardiac monitor for at least 24 h post-injury. Cardiac abnormalities were noted in four patients (3 per cent) during this period. Three patients had occasional ectopic beats which settled spontaneously over a 24 h period post-injury. The fourth patient developed atrial fibrillation (AF) after a high voltage injury which resolved following intravenous digoxin. Cardiac complications were more frequent in those who had experienced a loss of consciousness at the time of injury and in those who suffered a high voltage electrical injury. All of the patients with cardiac complications had these at the time of admission to hospital. This suggests that if there is no history of a loss of consciousness and the 12-lead ECG recorded on attendance at the hospital is normal, it is unlikely that the patient will go on to develop cardiac problems.