Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Feb 2014
Observational StudyMyocardial injury secondary to ICD shocks: insights from patients with lead fracture.
Patients who receive appropriate implantable cardioverter defibrillator (ICD) shocks have a subsequent adverse prognosis. Most data suggest that patients with inappropriate ICD shocks also have a subsequent adverse prognosis, although this is more controversial. The shocks may be an epiphenomenon, that is, a marker of underlying disease progression; however, it cannot be excluded that shocks cause direct myocardial damage. This latter question is difficult to clarify as the arrhythmia provoking the shock can also cause troponin release. Inappropriate shocks secondary to lead fracture are an ideal situation to examine this question; any troponin release in an otherwise well and hemodynamically stable patient, is likely due directly to the shocks. ⋯ Troponin elevation occurred in the majority of our patients after inappropriate ICD discharges secondary to lead fracture. This indicates that ICD shocks can cause myocardial injury.