Laptop Battery Mahidol University Annual Research Abstracts 2000 181 IMPROVED DETECTION OF RADIOFREQUENCY CURRENT- INDUCED MINOR MYOCARDIAL INJURY BY CARDIAC ROPONIN T MEASUREMENT Kosit Sribhen1, Kiertijai Bhuripanyo2, Ongarn Raungratanaamporn2, Sudcharee Kiartivich1, Wattana Leowattana1, Suphachai Chaithiraphan2 1Department of Clinical Pathology, 2Her Majesty's Cardiac Centre, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700. Thailand.
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Microsoft Key words : Radiofrequency ablation, Minor Myocardial Injury, Cardiac Troponin T
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Laptop Computer Transcatheter radiofrequency current application in patients with cardiac arrhythmias was reported to be associated with a low rate of an increase in the activity of enzyme creatine kinase (CK) and CK-MB isoenzyme. As the novel heart-specific protein troponin T (cTnT) was shown to be superior to CK and CK-MB in detecting small damage to myocardial tissue in various clinical situations including unstable angina, a comparison of the diagnostic efficiency of these marker proteins to detect myocardial damage was made in 34 patients (mean age 38.3 ± 15.6 years) undergoing radiofrequency (RF) catheter ablation of accessory pathways (n = 17) and atrioventricular nodal reentrant tachycardia (n = 17). Serial measurements of total CK and CK-MB activity before and every 8 hours for 24 hours after ablative procedure were performed with enzymatic and immunoinhibition method, respectively, using automated chemical analyzer Hitachi 717. Serum concentration of cTnT was determined by one-step sandwich ELISA performed on ES 300 analyzer (Boehringer Mannheim).
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Notebooks With a median of 7.0 (range 1-39) RF current pulses only 12 (35%) and 10 (29%) of 34 patients showed an increase above the upper limit of normal CK and CK-MB activity, respectively. The peak activity of CK (mean peak = 285.8 ± 517.7 IU/L) occurred at a variable time that infrequently coincided with those of peak CK-MB activity (23.1 ± 8.0 IU/L). By contrast, all except 4 (88 %) of 34 patients exhibited a distinct elevation of cTnT concentration (mean peak = 0.56 ± 0.63 ng/ml), with almost all (33) of these 34 patients showed an early peak value at 8 hours postprocedural. There was, on the average, a small but distinct higher relative increase (5.6 times) in cTnT concentration from the upper limit of reference range compared with those of CK (1.5 times) and CK-MB peak activity (0.9 time).
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Hard Drive In conclusion, cTnT exhibited a minor but distinct elevation in its concentration and demonstrated a higher rate and magnitude of increase following radiofrequency current application than the conventional CK and CK-MB isoenzyme. Measurements of cTnT serum concentration may thus provide a useful test method for assessing the effect of the new transcatheter ablation procedures on myocardial tissue.
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(J Med Assoc Thai 1999 ; 82 : 256-62.)
