Myocardial Injury After Radiofrequency Catheter Ablation
CHARN SRIRATANASATHAVORN, M.D.*,
ONGKARN RAUNGRATANAAMPORN, M.D.*,
KIERTUAI BHURIPANYO, M.D.*,
SANSERN CHARERNTHAI, M.D.*,
SUPHACHAI CHAITHIRAPHAN, M.D.*
WATT ANA LEOWATTANA, M.D.**,
RUNGROJ KRITTAYAPHONG,M.D.***,
CHARUWAN KANGKAGATE, M.S. (Biostat)*,
SASIKANT POKUM, B.Sc.**,
Affiliation : * Her Majesty Cardiac Center,
** Department of Clinical Pathology,
*** Division of Cardiology, Department of Medicine Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
AbstractRadiofrequency catheter ablation has been a good treatment option for various types of
cardiac arrhythmia. However there is concern about myocardial injury associated with radiofre-
quency catheter ablation. We studied myocardial injury with biochemical markers and echo-
cardiogram 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 echocardio-
grams 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.
Keywords : Myocardial Injury, Radiofrequency Catheter Ablation
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