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Heart 1998;80:226-228; doi:10.1136/hrt.80.3.226
Copyright © 1998 BMJ Publishing Group Ltd & British Cardiovascular Society

Heart 1998;80:226-228 ( September )

Cardiac troponin T does not increase after electrical cardioversion for atrial fibrillation or atrial flutter

K Greaves,a T Crakeb

a Department of Cardiology, St Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK, b Department of Cardiology, The North Middlesex Hospital, London N18, UK

Correspondence to: Dr Greaves.

Accepted for publication 31 March 1998

Objective---To determine whether cardiac troponin T increases after electrical cardioversion in patients with atrial fibrillation or atrial flutter.
Design---Serum creatine kinase (CK), creatine kinase-MB (CKMB), and cardiac troponin T were measured before, 24 hours, and 48 hours after cardioversion in 15 patients with atrial fibrillation or atrial flutter.
Results---12 of the 15 patients (80%) were successfully cardioverted to sinus rhythm. The median number of shocks was three (range one to six), the median cumulative energy 710 J (50 to 1430 J), and the median peak energy 300 J (50 to 360 J). Total CK increased from a baseline median concentration of 92 (45 to 259) to 1324 (96 to 6660) U/l at 24 hours and 1529 (120 to 4774) U/l at 48 hours after cardioversion. There was a small increase in CKMB but the ratio of CKMB to CK did not increase. There was no increase in cardiac troponin T in any patient.
Conclusions---Following electrical cardioversion of atrial fibrillation or atrial flutter, cardiac troponin T remains unchanged despite a large rise in total CK, indicating that the CK is derived from skeletal muscle and that myocardial injury does not occur. If cardiac troponin T is increased after cardioversion for atrial arrhythmias then other causes of myocardial damage should be sought.

Keywords: atrial fibrillation;  atrial flutter;  cardioversion;  troponin T

© 1998 by Heart
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  • Morrow, D.A., Antman, E.M. (2000). Cardiac marker elevation after cardioversion: sorting out chicken and egg. Eur Heart J 21: 171-173  
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