Troponin levels after cardiac electrophysiology procedures: Review of the literature

Mohamad A. Alaiti, Anjli Maroo, Thomas B. Edel

Research output: Contribution to journalReview articlepeer-review

20 Scopus citations


Cardiac-specific Troponins (cTn) I and T have become markers of choice for myocardial injury. We reviewed the literature in order to understand the expected postprocedure cTn rise after electrophysiology procedures. A total of 34 studies and 1,608 patients were included. After external monophasic cardioversion, seven of 442 patients (1.6%) had minimal increase in cTnI (0.1-0.9 ng/mL), and only one of 368 (0.3%) had increase in cTnT (0.11 ng/mL). After internal cardioversion, 17 of 105 (16%) had increase in cTnI (0.7-2.4 ng/mL) but only three (2.9%) were above the cutoff for myocardial infarction (MI) (1.5 ng/mL). During implantable cardioverter-defibrillator (ICD) installation with a mean of 2-7 ICD shocks, 12 of 74 (16%) patients had cTnI ≥1.5 ng/mL (range 1.7-5.5 ng/mL) and 20 of 64 (32%) had cTnT ≥0.1 ng/mL (range 0.26-6.46 ng/mL) considered in the range of clinical MI. Radio frequency ablation (RFA) (n = 496) resulted in significant cTn elevation in 25-100% of patients with ventricular > atrial and linear > focal lesions. Average postprocedure peak cTnI ranged from 0.13 to 6 ng/mL (median: 2.36 ng/mL, max: 15 ng/mL) and cTnT 0.2 to 2.41 ng/mL (median: 0.44 ng/mL, max: 9 ng/mL). Early cTn peak at 2-8 hours was noted after RFA. External cardioversion should not cause a significant increase in cTn; RFA and ICD implantation with shocks often result in an increase in cTn. Interpretation of these markers can be difficult if acute coronary syndrome is suspected in the postprocedure period. (PACE 2009; 32:800-810)

Original languageEnglish (US)
Pages (from-to)800-810
Number of pages11
JournalPACE - Pacing and Clinical Electrophysiology
Issue number6
StatePublished - Jun 2009
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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