Cardiac monitoring always required after electrical injuries?
BACKGROUND
Controversy still exists regarding inpatient monitoring of patients exposed to electrical injuries.


METHODS
In a monocentric retrospective study, we evaluated the medical records of 169 patients admitted to the University Hospital of Cologne from January 2000 to January 2014 because of electrical trauma. The electrocardiogram (ECG) data of 40 patients were missing.


RESULTS
Patients in our collective were predominantly young men (60 %) with an average age of 17.5 ± 17 years (1 year to 73 years). The electrical trauma occurred occupational (20 %), domestic (65 %), and during leisure time (15 %). In the high-voltage (≥ 1000 V) group (n = 7; 71 % male; 40.0 ± 19.4 years) one death was reported, related to an open intracranial injury and cardiac arrest. Of the six surviving patients five showed normal ECGs and one a sinus tachycardia. In the low-voltage (< 1000 V) group (n = 162, 56 % male; 5.0 ± 4.3 years) the ECG findings were as follows: 104 normal, 5 sinus tachycardia, 3 sinus arrhythmia, 6 ST segment changes, 3 premature atrial contraction, 1 premature ventricular contraction, 1 atrio-ventricular (AV)-Block and 1 delta wave. In all, one patient showed a self-limiting supraventricular tachycardia.


CONCLUSIONS
Asymptomatic and stable patients without any risk factors and with a normal initial ECG need no inpatient cardiac monitoring after an electrical injury.
Department of Internal Medicine III, University of Cologne, Kerpener-Str. 62, 50937, Cologne, Germany.
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C
Krämer
Department of Internal Medicine III, University of Cologne, Kerpener-Str. 62, 50937, Cologne, Germany.
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R
Pfister
Department of Internal Medicine III, University of Cologne, Kerpener-Str. 62, 50937, Cologne, Germany.
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T
Boekels
Department of Internal Medicine III, University of Cologne, Kerpener-Str. 62, 50937, Cologne, Germany. guido.michels@uk-koeln.de.
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Michels
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac; D002648:Child; D002675:Child, Preschool; D004556:Electric Injuries; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D055815:Young Adult
Cardiac arrhythmia; Cardiac monitoring; Electrical injury; High-voltage injury; Low-voltage injury