Automatic implantable cardioverter/defibrillator discharges and acute myocardial injury

Journal Article · Tue May 01 00:00:00 EDT 1990 · Circulation; (USA)

DOI:https://doi.org/10.1161/01.CIR.81.5.1482· OSTI ID:7015514

Avitall, B; Port, S; Gal, R; McKinnie, J; Tchou, P; Jazayeri, M; Troup, P; Akhtar, M ^[1]

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1. Univ. of Wisconsin-Milwaukee Clinical Campus (USA)

Multiple defibrillations by the automatic implantable cardioverter/defibrillator (AICD) have been reported to result in localized epicardial damage. No data exist, however, regarding whether this damage can be detected in the clinical setting or whether it interferes with the detection of true myocardial infarction. Forty-nine patients who received defibrillations by patch electrodes were studied prospectively. We attempted to document the presence of myocardial injury with the following three commonly used modalities for the detection of myocardial infarction: serial electrocardiographic changes, serial creatine phosphokinase (CPK) and CPK-MB release, and technetium 99m pyrophosphate scanning. Fifteen patients received defibrillations by AICD patches at the time of AICD generator replacement. Nine patients received defibrillations at the time of new AICD lead placement. The average total energy delivered was 85 +/- 29 J. None of these patients had detectable myocardial injury. Ten patients had defibrillations by the AICD patches at the time of bypass operation. One patient in this group developed acute myocardial infarction in the inferior wall after posterior descending coronary bypass operation, as detected by electrocardiogram, 99mTc pyrophosphate scanning, and CPK-MB analysis. Fifteen patients were evaluated for spontaneous AICD discharges. Thirteen had a maximum of five consecutive shocks, and cumulative energy delivered was not greater than 330 J. None of these patients had detectable injury. Two patients had CPK-MB release of 15.3% and 7.5%, respectively. One of these patients had a positive 99mTc pyrophosphate scan. These two patients received 12 and 17 rapid and consecutive AICD discharges, respectively, with cumulative delivered energy of 360 and 510 J, respectively.

• OSTI ID: 7015514
• Journal Information: Circulation; (USA), Vol. 81:5; ISSN 0009-7322
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
HEART
RADIOISOTOPE SCANNING
MYOCARDIAL INFARCTION
DIAGNOSIS
ELECTRIC SHOCK
ELECTROCARDIOGRAMS
IMPLANTS
ISOENZYMES
ISOMERIC NUCLEI
MAN
PATIENTS
PYROPHOSPHATES
TECHNETIUM 99
ANIMALS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BODY
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIAGRAMS
DISEASES
HOURS LIVING RADIOISOTOPES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MAMMALS
NUCLEI
ODD-EVEN NUCLEI
ORGANS
OXYGEN COMPOUNDS
PHOSPHORUS COMPOUNDS
PRIMATES
RADIOISOTOPES
TECHNETIUM ISOTOPES
VERTEBRATES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics