Abstract
Introduction: Cardiac troponins are highly specific markers of myocardial damage. The aim of our investigation was to determine the correlation between pacemaker implantation and elevation of cardiospecific markers.
Aim: To compare the elevation of troponin I in group of patients with the implantation of pacemaker (single or dual chamber) with active lead and unselected population of cardiologic patients. Method: A defined group of 230 patients were indicated for the pacemaker implantation.
The values of cardiospecific markers (troponin I, CKMB and myoglobin) were measured before the implantation and repeated 6 and 18 hours later. Monitored factors were fluoroscopic time, the number of attempts of pacemaker implantation (attachment to myocardium), single chamber versus dual chamber pacemaker implantation and other clinical data.
Results: The mean age was 77.9 +- 8.0 years (median 79.5). Females formed 44 % of the group.
A total of 136 double chamber and 94 single chamber pacemakers were implanted. The average time of fluoroscopy was 38.8 +- 22.0 seconds (median 33.5 s).
In the whole group of patients troponin I increased from the initial 0.02 +- 0.07 ug/l to 0.18 +- 0.17, p < 0.001 (Wilcoxon test) 6 hours later and decrease to 0.09 +- 0.18 ug/l 18 hours later, p < 0.001 (Wilcoxon test). There were minor changes in other cardiospecific markers.
The correlation between serum levels of troponin I after the implantation of pacemaker and fluoroscopic time in the whole group of 230 patients was set, (Spearman correlation coeficient =-0.39, p < 0.001 resp. 0.37, p < 0.001) after 6 and 18 hours respectively. Conclusion: A mild troponin I elevation after the uncomplicated pacemaker implantation with active lead electrode system is a common phenomenon.
We didnt find correlation betwen troponin I elevation and difficulty of the procedure.