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Bilchick KC, Morgounova E, Oomen P, Malhotra R, Mason PK, Mangrum M, Kim D, Gao X, Darby AE, Monfredi OJ, Aso JA, Franzen PM, Stadler RW. First-in-human noninvasive left ventricular ultrasound pacing: A potential screening tool for cardiac resynchronization therapy. Heart Rhythm O2 2023; 4:79-87. [PMID: 36873311 PMCID: PMC9975015 DOI: 10.1016/j.hroo.2022.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background A screening tool to predict response to cardiac resynchronization therapy (CRT) could improve patient selection and outcomes. Objective The purpose of this study was to investigate the feasibility and safety of noninvasive CRT via transcutaneous ultrasonic left ventricular (LV) pacing applied as a screening test before CRT implants. Methods P-wave-triggered ultrasound stimuli were delivered during bolus dosing of an echocardiographic contrast agent to simulate CRT noninvasively. Ultrasound pacing was delivered at a variety of LV locations with a range of atrioventricular delays to achieve fusion with intrinsic ventricular activation. Three-dimensional cardiac activation maps were acquired via the Medtronic CardioInsight 252-electrode mapping vest during baseline, ultrasound pacing, and after CRT implantation. A separate control group received only the CRT implants. Results Ultrasound pacing was achieved in 10 patients with a mean of 81.2 ± 50.8 ultrasound paced beats per patient and up to 20 consecutive beats of ultrasound pacing. QRS width at baseline (168.2 ± 17.8 ms) decreased significantly to 117.3 ± 21.5 ms (P <.001) in the best ultrasound paced beat and to 125.8 ± 13.3 ms (P <.001) in the best CRT beat. Electrical activation patterns were similar between CRT pacing and ultrasound pacing with stimulation from the same area of the LV. Troponin results were similar between the ultrasound pacing and the control groups (P = .96), confirming safety. Conclusion Noninvasive ultrasound pacing before CRT is safe and feasible, and it estimates the degree of electrical resynchronization achievable with CRT. Further study of this promising technique to guide CRT patient selection is warranted.
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Affiliation(s)
| | | | - Pim Oomen
- University of California Irvine, Irvine, California
| | - Rohit Malhotra
- University of Virginia Health System, Charlottesville, Virginia
| | - Pamela K Mason
- University of Virginia Health System, Charlottesville, Virginia
| | - Mike Mangrum
- University of Virginia Health System, Charlottesville, Virginia
| | - David Kim
- University of Virginia Health System, Charlottesville, Virginia
| | - Xu Gao
- Northwestern Medicine, Chicago, Illinois
| | - Andrew E Darby
- University of Virginia Health System, Charlottesville, Virginia
| | | | - Joy A Aso
- Medtronic plc, Mounds View, Minnesota
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Liu M, Wu P. Myocardial Injury After Temporary Transvenous Cardiac Pacing. Ther Clin Risk Manag 2021; 17:415-421. [PMID: 34040379 PMCID: PMC8140925 DOI: 10.2147/tcrm.s306065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/16/2021] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Temporary transvenous cardiac pacing (TTCP) can lead to potential penetration and occasional perforation of the right ventricular wall. No study to date has analyzed the effect of TTCP on myocardial injury by cardiac troponin (cTn) measurement. The present study was designed to investigate perioperative myocardial injury in elective TTCP in noncardiac surgical settings. PATIENTS AND METHODS This retrospective study investigated the data collected from August 2018 through March 2020 from 22 eligible patients who underwent elective TTCP for noncardiac procedures. The patients had a median age of 66 (50-83) years; six (27.3%) of them were women, and all of them had a baseline cTn <1 upper reference limit (URL). Cardiac biomarker assays were performed before and after TTCP, and their results were compared. RESULTS After TTCP, cTn > 1 URL was detected in 20 (91%, N=22) patients. Among these 22 patients, paired t-test comparing assay results before and after TTCP lead insertion showed a mean cTn elevation of 3.599 URL (95% CI: 1.566 to 5.632, P<0.01), and a mean creatine kinase-MB isoform elevation of 0.1550 URL (95% CI: -0.01239 to 0.3224, P>0.05). CONCLUSION The study demonstrates a high incidence of myocardial injury associated with TTCP, which should be a matter of concern for the involved physicians.
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Affiliation(s)
- Meng Liu
- Emergency Department, Hunan Provincial People’s Hospital, Medical School of Hunan Normal University, Changsha, People’s Republic of China
- Cardiology Department, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
| | - Pingsheng Wu
- Cardiology Department, Nanfang Hospital, Southern Medical University, Guangzhou, People’s Republic of China
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Griva M, Stastny J, Kopriva P, Slabak M, Coufal Z, Jarkovsky J, Svoboda M, Salek T, Sukupova L, Taborsky M. Selective coronary angiography, percutaneous coronary intervention and asymptomatic peri-procedural myocardial injury. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2018; 163:324-330. [PMID: 30398220 DOI: 10.5507/bp.2018.066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 10/15/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND While there have been a number of studies reporting the incidence and implications of elevated troponin levels after percutaneous coronary intervention (PCI), the body of information about the incidence, associations, and implications of elevated troponin levels following coronary angiography (CAG) is limited. MATERIALS AND METHODS A total of 220 consecutive patients with stable coronary artery disease or intermediate or low-risk acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS) were included in our study. High-sensitivity cardiac troponin I (hs-cTnI) levels were measured before and after coronary angiography (CAG) in patients with or without PCI and correlated with a number of clinical variables. RESULTS Hs-cTnI elevations above the 99th percentile upper reference limit (URL), or above 20% of the initially positive, yet already declining values, were found in 60 (37.2%) patients after CAG and in 45 (76.2%) patients undergoing PCI. Significant correlations of hs-cTnI elevation were found with the following variables: volume of contrast, fluoroscopy time, dose-area product, amount of contrast agent injected directly into the coronary arteries, total time of balloon dilation and the number and total length of implanted stents (P<0.001 for all). CONCLUSION While an asymptomatic elevation of hs-cTnI is a common finding after PCI, it does occur, quite surprisingly, also after CAG. Despite contradictory views regarding the clinical relevance of asymptomatic post-procedural elevated hs-cTnI levels, it is generally believed that a mild elevation is not associated with an increased risk. Still, it may pose a diagnostic quandary following a successful interventional procedure and even more so after an uncomplicated CAG. TRIAL REGISTRATION Clinicaltrials.gov - NCT02960321.
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Affiliation(s)
- Martin Griva
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic.,Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
| | - Jiri Stastny
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Petr Kopriva
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Martin Slabak
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Zdenek Coufal
- Cardiovascular Center for Adults, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Jiri Jarkovsky
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Michal Svoboda
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Tomas Salek
- Department of Clinical Biochemistry, Tomas Bata Regional Hospital, Zlin, Czech Republic
| | - Lucie Sukupova
- Department of the Director, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Milos Taborsky
- Department of Internal Medicine I - Cardiology, University Hospital Olomouc, Czech Republic
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Varvarousis D, Goulas N, Polytarchou K, Psychari SN, Paravolidakis K, Konstantinidou A, Tsoukalas D, Vlad D, Bouki K, Kotsakis A. Biomarkers of Myocardial Injury and Inflammation after Permanent Pacemaker Implantation: The Lead Fixation Type Effect. J Atr Fibrillation 2018; 10:1798. [PMID: 29988295 DOI: 10.4022/jafib.1798] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 01/19/2018] [Accepted: 02/14/2018] [Indexed: 11/10/2022]
Abstract
Background Permanent pacemaker implantation is accompanied by minor myocardial damage, indicated by elevated serum levels of cardiac biomarkers. Aim of this prospective study was to comparably investigate the lead fixation type effect on the extent of myocardial injury and inflammation following pacemaker implantation, and to assess the possible clinical implications. Methods Cardiac troponin I (cTnI) and C-reactive protein (CRP) were measured at baseline, 6 and 24h after implantation in 101 patients, categorized into the active and passive lead fixation group. Patients were followed up for clinical adverse events or abnormal pacing parameters at 24h, 7 and 30 days post-procedure. Results cTnI increased at 6h post-procedure (p<0.05) in 23.8% of patients, and returned to baseline after 24h. The passive group demonstrated significantly higher cTnI at 6h compared to the active group (p=0.006). CRP increased significantly at 6h, and maintained an upward trend after 24h (p<0.01) in both groups. The active group demonstrated significantly higher CRP at 6h compared to the passive group. We did not identify an association of positive biomarkers with adverse events. Conclusion cTnI and CRP can increase early after permanent pacemaker implantation, indicating mechanical myocardial injury and inflammation. The extent of these biomarkers elevation depends on the lead fixation type, and is not related to worse short-term prognosis.
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Affiliation(s)
- Dimitrios Varvarousis
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Nikolaos Goulas
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Kali Polytarchou
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Stavroula N Psychari
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Konstantinos Paravolidakis
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Agapi Konstantinidou
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Dionysios Tsoukalas
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Delia Vlad
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Konstantina Bouki
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
| | - Athanasios Kotsakis
- 2nd Department of Cardiology, General Hospital of Nikea-Piraeus "Agios Panteleimon", D. Mantouvalou 3, 18454, Piraeus, Greece
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Blažek P, Ferri-Certić J, Vražić H, Lennerz C, Grebmer C, Kaitani K, Karch M, Starčević B, Semmler V, Kolb C. Pacemaker Implantation Associated Myocardial Micro-Damage: A Randomised Comparison between Active and Passive Fixation Leads. Sci Rep 2018; 8:4870. [PMID: 29559697 PMCID: PMC5861101 DOI: 10.1038/s41598-018-23209-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/07/2018] [Indexed: 12/24/2022] Open
Abstract
Fixation of the pacemaker leads during pacemaker implantation leads to an increase of cardiac Troponin T (cTnT) that can be interpreted as a sign of minimal myocardial damage. This trial evaluates whether the mechanism type of lead fixation influences the magnitude of cTnT release. Patients having a de-novo cardiac pacemaker implantation or a lead revision were centrally randomized to receive either a ventricular lead with an active (screw) or passive (tine) fixation mechanism. High-sensitive Troponin T (hsTnT) was determined on the day of the procedure beforehand and on the following day. 326 Patients (median age (IQR) 75.0 (69.0–80.0) years, 64% male) from six international centers were randomized to receive ventricular leads with an active (n = 166) or passive (n = 160) fixation mechanism. Median (IQR) hsTnT levels increased by 0.009 (0.004–0.021) ng/ml in the group receiving screw-in ventricular leads and by 0.008 (0.003–0.030) ng/ml in the group receiving tined ventricular leads (n.s.). In conclusion pacemaker implantations are followed by a release of hsTnT. The choice between active or passive fixation ventricular leads does not have a significant influence on the extent of myocardial injury and the magnitude of hsTnT release.
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Affiliation(s)
- Patrick Blažek
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany.
| | | | - Hrvoje Vražić
- University Hospital Dubrava, Division of Cardiology, Department of Internal Medicine, Zagreb, Croatia
| | - Carsten Lennerz
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Christian Grebmer
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany
| | | | - Martin Karch
- Klinikverbund Kempten-Oberallgäu, Abteilung für Kardiologie, Kempten, Germany
| | - Boris Starčević
- University Hospital Dubrava, Division of Cardiology, Department of Internal Medicine, Zagreb, Croatia
| | - Verena Semmler
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany
| | - Christof Kolb
- Deutsches Herzzentrum München, Klinik für Herz- und Kreislauferkrankungen, Abteilung für Elektrophysiologie, Fakultät für Medizin der Technischen Universität München, Munich, Germany
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6
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Chen X, Yu Z, Bai J, Hu S, Wang W, Qin S, Wang J, Sun Z, Su Y, Ge J. Troponin T elevation after permanent pacemaker implantation. J Interv Card Electrophysiol 2017; 49:211-218. [DOI: 10.1007/s10840-017-0247-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
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7
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Trafny DJ, Oyama MA, Wormser C, Reynolds CA, Singletary GE, Peddle GD. Cardiac troponin-I concentrations in dogs with bradyarrhythmias before and after artificial pacing. J Vet Cardiol 2010; 12:183-90. [PMID: 21030328 DOI: 10.1016/j.jvc.2010.07.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2010] [Revised: 07/22/2010] [Accepted: 07/23/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To quantify cardiac troponin-I (cTnI) concentration in dogs with symptomatic bradyarrhythmias before and after artificial pacing and to correlate cTnI concentration with diagnosis, echocardiographic parameters, serology, and outcome. ANIMALS, MATERIALS AND METHODS Medical records from the University of Pennsylvania from 2006 to 2009 were reviewed, and 14 dogs with cTnI assay results before and after pacemaker were identified. The ECG diagnosis included complete atrioventricular block (AVB), sick sinus syndrome, 2nd degree AVB, and atrial standstill. Serology, presence of premature beats, echocardiographic measurements, and pacing modality were recorded. RESULTS Mean cTnI concentration was elevated both pre- and post-pacing, and was significantly higher pre-pacing vs. post-pacing. Post-pacing cTnI concentration in 9 of 14 dogs (64%) remained above the reference range. Four dogs yielded high serum titers for Bartonella spp. Four dogs with markedly increased cTnI concentration had progressive left ventricular enlargement and myocardial failure as compared to pre-pacing examination. CONCLUSIONS Elevated cTnI concentration suggests that cardiac injury persists after artificial pacing in dogs with bradyarrhythmias. Myocarditis secondary to Bartonella spp. or other causes may be an important cause of AVB in dogs. Prospective studies investigating the correlation of cTnI to potential etiology and development of post-pacing LV dysfunction and outcome are needed.
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Affiliation(s)
- Dennis J Trafny
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, MJR-VHUP-Cardiology, 3900 Delancey St., Philadelphia, PA 19104, United States
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8
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Fonfara S, Loureiro J, Swift S, James R, Cripps P, Dukes-McEwan J. Cardiac troponin I as a marker for severity and prognosis of cardiac disease in dogs. Vet J 2009; 184:334-9. [PMID: 19703781 DOI: 10.1016/j.tvjl.2009.04.004] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2008] [Revised: 03/31/2009] [Accepted: 04/02/2009] [Indexed: 11/20/2022]
Abstract
The use of cardiac troponin I (cTnI) to assess the severity of disease and prognosis in 120 dogs presented for cardiac evaluation was analysed. cTnI concentrations were measured using a commercially available assay. Dogs were placed into three groups: group 1, cTnI0.15ng/mL; group 2, cTnI 0.151-1.0ng/mL; group 3, cTnI>1.01ng/mL. Dogs in group 1 were significantly younger (P<0.0001) and had no or stable cardiac diseases and longest survival times, whereas those in groups 2 and 3 had severe cardiac diseases and significantly reduced survival times (P<0.0001). Thirty dogs with initially increased cTnI concentrations had a repeat assay less than 2months later with significant reductions in cTnI concentrations (P=0.005). Initial cTnI concentrations could not differentiate dogs that survived in group 3 from those that did not. However, dogs that survived showed significant cTnI reductions (P=0.015) in the repeated assay in contrast to the dogs that died (P=0.22). It was concluded that cTnI is useful in assessing the prognosis and severity of cardiac diseases in dogs, and progression and response to treatment can be assessed by repeat sampling. cTnI concentrations >1.0ng/mL and persistent increases in cTnI concentrations are indicators of a poor prognosis in dogs with cardiac disease.
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Affiliation(s)
- S Fonfara
- Small Animal Teaching Hospital, University of Liverpool, Neston, School of Veterinary Science, Leahurst, Neston CH64 7TE, UK.
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Martignani C, Diemberger I, Biffi M, Ziacchi M, Saporito D, Valzania C, Bertini M, Domenichini G, Branzi A, Boriani G. Troponin I rise after pacemaker implantation at the time of "universal definition of myocardial infarction". Am J Cardiol 2009; 103:1061-5. [PMID: 19361590 DOI: 10.1016/j.amjcard.2009.01.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 01/05/2009] [Accepted: 01/05/2009] [Indexed: 11/29/2022]
Abstract
We assessed incidence, magnitude, and time course of cardiac troponin I (cTnI) increase after pacemaker implantation in patients without acute coronary syndromes (ACSs). Seventy patients (mean age 71 years, interquartile range 44 to 92, 38 men) undergoing elective implantation of a single-/dual-chamber pacemaker with active/passive fixation leads were enrolled, excluding subjects with clinical suspicion of ACS, abnormal basal cTnI level, or presenting conditions predisposing to abnormal cTnI. Cardiac TnI concentrations were determined in basal conditions, at the end of the procedure, and after 8, 12, and 24 hours. Single-/dual-chamber devices were implanted in 31 of 39 patients. Cardiac TnI peak concentration occurred within the 12-hour assay in 69 of 70 patients; 26 of 70 had a cTnI above the normal cut-off range. All patients presented normal cTnI at 24-hour assay. In conclusion, pacemaker implantation is associated with increases of cTnI levels in up to 37% of patients. This can affect the specificity of cTnI assessment for ruling out ACS, especially within 12 hours after the procedure. These data deserve consideration in a contemporary setting, in which troponin has gathered a pivotal role in the diagnosis and therapy of ACS, and in particular clinical presentations in which electrocardiogram loses its diagnostic capabilities (due to paced rhythms) and symptoms may be lacking or confusing.
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Altin T, Akyurek O, Vurgun K, Beton O, Sayin T, Kilickap M, Karaoguz R, Guldal M, Erol C. Effect of transvenous cardiac resynchronization therapy device implantation on cardiac troponin I release. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2008; 30:1356-62. [PMID: 17976099 DOI: 10.1111/j.1540-8159.2007.00871.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Pacemaker and implantable cardioverter defibrillator (ICD) implantation increases cardiac troponin I (cTnI) levels which indicates myocardial injury. During implantation of a cardiac resynchronization therapy (CRT) device, balloon inflation for coronary sinus (CS) venogram, cannulation of CS side branch, and electrode advancement may interfere with CS drainage and, hence, may decrease the washout of toxic metabolites from the heart. Thus, CRT implantation may further increase cTnI levels. In this study, we investigated the effects of CRT implantation on cTnI release. METHODS We included 10 patients (mean age = 57 +/- 15 years) in whom a successful transvenous CRT system was implanted (CRT group). Twenty patients (mean age = 65 +/- 10 years) who underwent a transvenous pacemaker or ICD implantation were included as the control group. Blood samples for cTnI were drawn at baseline and at six, 12, 18, and 24 hours thereafter. RESULTS Baseline median cTnI levels were similar in CRT and control groups (0.03 ng/mL vs 0.02 ng/mL, respectively; P = 0.1). Postoperative cTnI levels during 24 hours were significantly higher in the CRT group (P < 0.05) by two-way repeated measures of analysis of variance. Post hoc analysis revealed that cTnI levels were higher at the 6th, 12th, 18th, and 24th hours compared to baseline levels (P < 0.001, P < 0.001, P < 0.01, and P < 0.01, respectively). There was a significant difference in the area under the curves (AUCs) of cTnI measurements (1.79 hr.ng/mL in the CRT group and 0.78 hr.ng/mL in the control group, P < 0.05). CONCLUSION Postoperative cTnI levels were higher after CRT implantation than simple pacemaker/ICD implantation. This may be due to CS manipulation during CRT implantation.
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Affiliation(s)
- Timucin Altin
- Ankara University School of Medicine, Department of Cardiology, Ankara, Turkey.
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11
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SBAROUNI EFTIHIA, GEORGIADOU PANAGIOTA, PANAGIOTAKOS DEMOSTHENES, LIVANIS EFTHIMIOS, THEODORAKIS GEORGEN, KREMASTINOS DIMITRIOSTH. The Ischemia-Modified Albumin in Relation to Pacemaker and Defibrillator Implantation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2007; 31:83-7. [DOI: 10.1111/j.1540-8159.2007.00929.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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