title: High Sensitivity Cardiac Troponin T Levels after Elective Cardioversion for Atrial Fibrillation/Flutter.
abstract: BACKGROUND
  The kinetics of high sensitivity cardiac troponin T (hs-cTnT) levels after elective, biphasic, direct-current cardioversion for persistent atrial fibrillation/flutter remains unknown.
  
  
  METHODS
  We examined hs-cTnT kinetics in 24 patients at baseline and at 2, 6 and 24 hours post-cardioversion, and again at 7 and 30 days. We also examined levels of creatine kinase, aspartate aminotransferase, lactate dehydrogenase, brain natriuretic peptide (BNP), and high sensitivity C-reactive protein (hs-CRP).
  
  
  RESULTS
  Median (25th, 75th interquartiles) baseline hs-cTnT concentration was 19.8 (10.4, 35.2) ng/L with 14 patients presenting with levels above the 99th percentile (13 ng/L). Hs-cTnT levels did not change significantly over time although they tended to decrease by 30 days, 18.8 ng/L (12.5, 23.3). There was no significant rise in other markers of myocardial injury. Similarly, BNP and hs-CRP levels were elevated at baseline and tended to decrease over time.
  
  
  CONCLUSIONS
  Patients with persistent atrial fibrillation/flutter have elevated hs-cTnT levels, as part of a general rise in biomarkers such as BNP and hs-CRP, without a further rise after cardioversion. After cardioversion, there is a gradual non-significant decrease in biomarker levels over time, and thus a rise in hs-cTnT levels should not be attributed to cardioversion.
authors.forename: Zaza
authors.initials: Z
authors.lastname: Iakobishvili
authors.forename: Adaya
authors.initials: A
authors.lastname: Weissler
authors.forename: Kiril
authors.initials: K
authors.lastname: Buturlin
authors.forename: Gustavo
authors.initials: G
authors.lastname: Goldenberg
authors.forename: Boris
authors.initials: B
authors.lastname: Strassberg
authors.forename: Ruth
authors.initials: R
authors.lastname: Tur
authors.forename: David
authors.initials: D
authors.lastname: Hasdai
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000628:therapy*; D001282:Atrial Flutter / Q000628:therapy*; D015415:Biomarkers / Q000378:metabolism; D004554:Electric Countershock / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D020107:Troponin T / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D020107:Troponin T