Detection of myocardial injury during radiofrequency catheter ablation by measuring serum cardiac troponin I levels: procedural correlates
Antonis S. Manolis, MD, FACC*  ,
Vassilis Vassilikos, MD*,
Themos Maounis, MD, FACC*,
Helen Melita-Manolis, MD*,
Lefteris Psarros, PhD*,
Alex Haliasos, MD* and
Dennis V. Cokkinos, MD, FACC*
* Onassis Cardiac Surgery Center, Athens, Greece
Patras University, Patras, Greece
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Figure 1 Baseline, post-procedural and late (4–24 h) serum cTnI levels in 118 patients undergoing RFA and in 39 control patients having EPS alone. cTnI = cardiac troponin I; EPS = electrophysiologic studies; RFA = radiofrequency ablation. *p = NS; **p = 0.001; *** p < 0.001.
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Figure 2 Procedural factors affecting peak cTnI levels during RF ablation include site of RF ablation and number of RF lesions produced. Highest cTnI levels are measured during ablation of ventricular myocardium (V-site), intermediate levels during ablation of atrial myocardium (Atrial site) and lowest levels during ablation at annular sites. With a TS approach to the mitral annulus, where lesions are applied to the atrial aspect, cTnI levels are lower compared with a TAo approach with lesions mainly applied at the ventricular aspect. When more than 10 RF lesions are produced, cTnI levels are significantly higher than with fewer lesions. cTnI = cardiac troponin I; RF = radiofrequency; TAo = transaortic; TS = transseptal.
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