2007 Volume 14 Issue 2 Pages 165-170
Electric countershock may cause injury to skeletal muscle with the elevations of cardiac troponin T (cTnT) and heart-type fatty acid-binding protein (h-FABP), and subsequently may affect the results of whole blood panel tests. A total of 27 patients with atrial flutter (n = 2) or atrial fibrillation (n = 25) were enrolled. Patients underwent electric countershock and blood sampling for cTnT and h-FABP at baseline and at various time points (immediately, 3, 6, and 24-hr after procedure). Whole blood panel tests for cTnT and h-FABP were also performed at the respective time points. Mean h-FABP was elevated 2.3 fold after electric countershock (P < 0.05), while there was no change in cTnT. The positive rates with the whole blood panel test was significantly higher for h-FABP than for cTnT at each time point (maximum diversity h-FABP: 55.6% v.s. cTnT: 0% at 3-hr after EC, P < 0.01). Electric countershock did not result in elevation of cTnT despite a rise in h-FABP. These data suggest that myocardial damage following electric countershock was minimal and that elevation of h-FABP may result from skeletal muscle damage. Thus, cTnT may be a more clinically useful for diagnostic indicator of myocardial damage. Furthermore, the whole blood panel test for cTnT has superiority to that for h-FABP following resuscitation, as levels are not affected by electric countershock.
