Cardiac monitoring of high-risk patients after an electrical injury: A prospective multicentre study

Abstract

Objective: To report our experience monitoring patients with previously identified theoretical risk factors of significant electrical injury. Methods: Patients who presented to one of 21 emergency departments between October 2000 and November 2004 were eligible to be enrolled in a prospective observational cohort study if after an electric shock they had one of several risk factors (transthoracic current, tetany, loss of consciousness or voltage source ≥1000 V) and therefore needed cardiac monitoring. Results: Of the 134 patients enrolled, most were monitored because of transthoracic current (n=60), transthoracic current and tetany (n=39), tetany (n = 10), or voltage≥1000 V (n = 10). There were 15/134 (11%) patients with abnormal initial ECGs. No patient developed potentially lethal late arrhythmia during the 24 hours of cardiac monitoring. Conclusion: Although only patients deemed at risk of late arrhythmias were monitored, none developed potentially lethal late arrhythmias. Asymptomatic patients with transthoracic current and/or tetany and a normal initial ECG do not require cardiac monitoring after an electrical injury with voltage < 1000 V and no loss of consciousness.