Myocardial injury after radiofrequency catheter ablation.

Abstract

Radiofrequency catheter ablation has been a good treatment option for various types of cardiac arrhythmia. However there is concern about myocardial injury associated with radiofrequency catheter ablation. We studied myocardial injury with biochemical markers and echocardiogram in 41 consecutive patients who underwent electrophysiology study (EP study) and radiofrequency catheter ablation (RFCA) at our institute from April to July 2000. The concentration of biochemical markers (CK-MB mass, troponin T and myoglobin) and result of the echocardiograms were analyzed with other characteristics. In 41 patients subjected to EP study with possible RFCA, abnormal levels of troponin T, CK-MB mass and myoglobin were found in 46 per cent, 15 per cent and 44 per cent immediately after procedure, which went up to 64 per cent, 22 per cent and 2 per cent at twenty four hours. Compare to the group with normal troponin T level, the patients with abnormal level at 24 hours after RFCA had a longer procedure time (119+/-44 min. vs 90+/-22 min.), more frequent use of impedance ablation catheters (65% vs 27%), more RF applications (9+/-8 vs 18+/-16) and more ventricular ablation sites (69% vs 9%). The echocardiogram results showed no remarkable abnormality in any patients. Troponin T was the most sensitive marker to detect thermal myocardial injury associated with radiofrequency catheter ablation. Prolonged procedure time, RF applications, the use of impedance ablation catheter and ventricular ablation site were associated with elevated troponin T concentration after RFCA.

AI evidence extraction

Main findings

Among 41 patients, abnormal troponin T, CK-MB mass, and myoglobin were observed in 46%, 15%, and 44% immediately after the procedure, and in 64%, 22%, and 2% at 24 hours, respectively. Patients with abnormal troponin T at 24 hours had longer procedure times, more frequent use of impedance ablation catheters, more RF applications, and more ventricular ablation sites compared with those with normal troponin T. Echocardiograms showed no remarkable abnormalities in any patients.

Outcomes measured

• Biochemical markers of myocardial injury (troponin T, CK-MB mass, myoglobin)
• Echocardiogram abnormalities
• Associations between procedural characteristics and elevated troponin T

Limitations

• Single-institute study
• Short follow-up limited to immediate and 24-hour post-procedure measurements
• No frequency, power, or dosimetry details for radiofrequency exposure reported in abstract

{
    "study_type": "cohort",
    "exposure": {
        "band": null,
        "source": "radiofrequency catheter ablation",
        "frequency_mhz": null,
        "sar_wkg": null,
        "duration": null
    },
    "population": "Patients undergoing electrophysiology study (EP study) with possible radiofrequency catheter ablation at a single institute (April–July 2000)",
    "sample_size": 41,
    "outcomes": [
        "Biochemical markers of myocardial injury (troponin T, CK-MB mass, myoglobin)",
        "Echocardiogram abnormalities",
        "Associations between procedural characteristics and elevated troponin T"
    ],
    "main_findings": "Among 41 patients, abnormal troponin T, CK-MB mass, and myoglobin were observed in 46%, 15%, and 44% immediately after the procedure, and in 64%, 22%, and 2% at 24 hours, respectively. Patients with abnormal troponin T at 24 hours had longer procedure times, more frequent use of impedance ablation catheters, more RF applications, and more ventricular ablation sites compared with those with normal troponin T. Echocardiograms showed no remarkable abnormalities in any patients.",
    "effect_direction": "harm",
    "limitations": [
        "Single-institute study",
        "Short follow-up limited to immediate and 24-hour post-procedure measurements",
        "No frequency, power, or dosimetry details for radiofrequency exposure reported in abstract"
    ],
    "evidence_strength": "low",
    "confidence": 0.7399999999999999911182158029987476766109466552734375,
    "peer_reviewed_likely": "yes",
    "keywords": [
        "radiofrequency catheter ablation",
        "myocardial injury",
        "troponin T",
        "CK-MB mass",
        "myoglobin",
        "echocardiogram",
        "thermal injury",
        "procedural factors"
    ],
    "suggested_hubs": []
}

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