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Original ArticleOpen Access
Improved Detection of Radiofrequency Current-Induced Minor Myocardial Injury by Cardiac Troponin T Measurement
Sribhen K 
,
Bhuripanvo K ,
Raungratanaamporn O ,
Kiartivich S ,
Leowattana W ,
Chaithiraphan S
,
Bhuripanvo K ,
Raungratanaamporn O ,
Kiartivich S ,
Leowattana W ,
Chaithiraphan S Transcatheter radiofrequency current application in patients with cardiac arrhythmias was
reported to be associated with a low rate of an increase in the activity of enzyme creatine kinase (CK)
and CK-MB isoenzyme. As the novel heart-specific protein troponin T (cTnT) was shown to be
superior to CK and CK-MB in detecting small damage to myocardial tissue in various clinical
situations including unstable angina, a comparison of the diagnostic efficiency of these marker
proteins to detect myocardial damage was made in 34 patients (mean age 38.3 ± 15.6 years)
undergoing radiofrequency (RF) catheter ablation of accessory pathways (n = 17) and atrioventricular
nodal reentrant tachycardia (n = 17). Serial measurements of total CK and CK-MB
activity before and every 8 hours for 24 hours after ablative procedure were performed with
enzymatic and immunoinhibition method, respectively, using automated chemical analyLer
Hitachi 717. Serum concentration of cTnT was determined by one-step sandwich ELISA performed
on ES 300 analyzer (Boehringer Mannheim).
With a median of 7.0 (range 1-39) RF current pulses only 12 (35%) and 10 (29%) of 34
patients showed an increase above the upper limit of normal CK and CK-MB activity, respectively.
The peak activity of CK (mean peak= 285.8 ± 517.7 lUlL) occurred at a variable time that
infrequently coincided with those of peak CK-MB activity (23.1 ± 8.0 IU/L). By contrast. all
except 4 (88%) of 34 patients exhibited a distinct elevation of cTnT concentration (mean peak =
0.56 ± 0.63 ng/ml), with almost all (33) of these 34 patients showed an early peak value at 8
hours postprocedural. There was, on the average, a small but distinct higher relative increase
(5.6 times) in cTnT concentration from the upper limit of reference range compared with those of
CK (1.5 times) and CK-MB peak activity (0.9 time).
In conclusion, cTnT exhibited a minor but distinst elevation in its concentration and
demonstrated a higher rate and magnitude of increase following radiofrequency current application
than the conventional CK and CK-MB isoenzyme. Measurements of cTnT serum concentration
may thus provide a useful test method for assessing the effect of the new transcatheter
ablation procedures on myocardial tissue.
Key word : Cardiac Troponin T Measurement, Minor Myocardial Injury, Radiofrequency CurrentInduction, Improved Detection
reported to be associated with a low rate of an increase in the activity of enzyme creatine kinase (CK)
and CK-MB isoenzyme. As the novel heart-specific protein troponin T (cTnT) was shown to be
superior to CK and CK-MB in detecting small damage to myocardial tissue in various clinical
situations including unstable angina, a comparison of the diagnostic efficiency of these marker
proteins to detect myocardial damage was made in 34 patients (mean age 38.3 ± 15.6 years)
undergoing radiofrequency (RF) catheter ablation of accessory pathways (n = 17) and atrioventricular
nodal reentrant tachycardia (n = 17). Serial measurements of total CK and CK-MB
activity before and every 8 hours for 24 hours after ablative procedure were performed with
enzymatic and immunoinhibition method, respectively, using automated chemical analyLer
Hitachi 717. Serum concentration of cTnT was determined by one-step sandwich ELISA performed
on ES 300 analyzer (Boehringer Mannheim).
With a median of 7.0 (range 1-39) RF current pulses only 12 (35%) and 10 (29%) of 34
patients showed an increase above the upper limit of normal CK and CK-MB activity, respectively.
The peak activity of CK (mean peak= 285.8 ± 517.7 lUlL) occurred at a variable time that
infrequently coincided with those of peak CK-MB activity (23.1 ± 8.0 IU/L). By contrast. all
except 4 (88%) of 34 patients exhibited a distinct elevation of cTnT concentration (mean peak =
0.56 ± 0.63 ng/ml), with almost all (33) of these 34 patients showed an early peak value at 8
hours postprocedural. There was, on the average, a small but distinct higher relative increase
(5.6 times) in cTnT concentration from the upper limit of reference range compared with those of
CK (1.5 times) and CK-MB peak activity (0.9 time).
In conclusion, cTnT exhibited a minor but distinst elevation in its concentration and
demonstrated a higher rate and magnitude of increase following radiofrequency current application
than the conventional CK and CK-MB isoenzyme. Measurements of cTnT serum concentration
may thus provide a useful test method for assessing the effect of the new transcatheter
ablation procedures on myocardial tissue.
Key word : Cardiac Troponin T Measurement, Minor Myocardial Injury, Radiofrequency CurrentInduction, Improved Detection
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