Direct Current Cardioversion

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Abstract
Creatine kinase (CK), lactic dehydrogenase (LDH), and more recently their isoenzyme determinations (CK-MB and LDH1) have been useful adjuncts in verification of myocardial injury. To determine whether DC cardioversion affects these serum enzyme levels, we recorded total CK, total LDH, CK-MB, and LDH1levels serially during 24 hours following elective DC cardioversion in 18 patients without cardiac ischemia. New postcardioversion elevations in total CK and total LDH levels were small and occasional: CK (one of 18 patients), LDH (four of 18 patients). Elevations of CK-MB or LDH1following cardioversion did not develop in any of the patients. Therefore, new CK-MB or LDH1elevations associated with arrhythmias must result from myocardial damage to DC cardioversion. (JAMA239:122-124, 1978)