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Effect of topic defibrillation on serum markers of myocardial damage

Department of Cardiac Surgery, St. Andrea Hospital, University of Rome ‘La Sapienza’, via di Grottarossa 1035-1039, 00189 Rome, Italy

*Corresponding author: Caterina Simon, Via di Monte del Gallo n°6, 00165 Roma. Tel.: +39-3803913635; fax: +39-06-80345310.

E-mail address: caterinasimon{at}hotmail.com (C. Simon).

Serum levels of cardiac enzymes and troponins after external cardioversion (ECV) for atrial defibrillation and atrial flutter, and after endocardiac cardioverter defibrillation by implantable cardioverter defibrillator (ICD), have been well investigated. The aim of this study was to assess the effects of topic defibrillation (TD), after cardiac surgery, on cardiac enzymes in patients with uncomplicated clinical course. Biochemical markers were analyzed prospectively for 20 patients after TD (group A) and for 20 patients that were not defibrillated (Control group). We obtained serum concentrations of cardiac Troponin I (cTnI), total creatine–kinase (CK), CK MB isoenzyme (CK-MB), Myoglobin (Myo) in both groups. The difference in cTnI plasma level and curve of raise was not statistically significant between the two groups, but there was a difference in the CK-MB and Myoglobin curve of raise between the two groups. Topic defibrillation does not influence the increase of cTnI, so a high cTnI should be correlated to myocardial damage and not to TD. In patients that received TD, it would be preferable to use cTnI as a marker of myocardial disease than CK-MB which is influenced by the TD.

Key Words: Defibrillation; Myocardial injury; Surgery complication