Timing and magnitude of serum creatine kinase-MB after transcatheter cardiac tissue fulguration in man

John Lesser, Irvin F. Goldenberg, Simon Milstein, Ann Dunnigan, David Dunbar, Charles C. Gornick, Walter Reyes, David G Benditt

Research output: Contribution to journalArticlepeer-review


This study examined the impact of transcatheter fulguration on creatine kinase-MB release in 21 patients (age range 17-71 years). Arrhythmia diagnoses were ventricular tachycardia 9, atrial fibrillation with a rapid ventricular response 7, atrioventricular nodal reentry 2, and reciprocating tachycardia utilizing a posteroseptal accessory pathway 3. Seven patients had apparently normal hearts while 8 had ischemic heart disease and 6 cardiomyopathy. Timing of initial elevated creatine kinase-MB activity (mean 1.34 ± 0.69 SD hours) and peak creatine kinase-MB activity (mean 3.73 ± 0.89 SD hours) was relatively uniform in all patients. Time to peak creatine kinase-MB activity was unrelated to either underlying cardiac disease (normal: 3.9 ± 1.0 hours; ischemic heart disease: 3.5 ± 0.9 hours; cardiomyopathy: 3.8 ± 0.9 hours), or fulguration site (His bundle (n = 9): 4.2 ± 0.9 hours, proximal coronary sinus (n = 3): 3.3 ± 0.3 hours, ventricle (n = 9): 3.4 ± 0.8 hours). The magnitude of peak serum creatine kinase-MB activity was independent of myocardial diagnosis or fulguration site, but was linearly related to total energy delivered (r = 0.5, P < 0.022). The latter correlation was particularly strong within cardiac diagnosis subgroups (normal: r = 0.92, P < 0.002; ischemic heart disease: 0.73, P < 0.04; non-ischemic cardiomyopathy: r = 0.57, P = NS). Thus, serum creatine kinase-MB activity following transcatheter fulguration is linearly related to the magnitude of delivered energy, and is similar to that observed after transient coronary artery occlusion and reperfusion.

Original languageEnglish (US)
Pages (from-to)83-91
Number of pages9
JournalInternational Journal of Cardiology
Issue number1
StatePublished - Jan 1990

Bibliographical note

Funding Information:
Dr. Reyes was supported in part by funds from the Minnesota Medical Foundation-Electrophysiology Research Fund.


  • Cardiac arrhythmia
  • Creatine kinase-MB activity
  • Electrode catheter
  • Fulguration


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