Conclusion
In conclusion, synchronised DC cardioversion of an atrial arrhythmia did not cause myocardial injury 6-hours post-cardioversion, as measured by the highly sensitive cardiac troponin I. Sub-group analysis stratifying by the presences of a cardiomyopathy suggests that cardioversion of patients with a cardiomyopathy may result in normalization of troponin I and thus an improvement in myocardial strain or injury. These data suggest that elevations in troponin post-cardioversion should be taken as a serious complication and investigated further. Finally, it may be of benefit for patients with cardiomyopathy and atrial arrhythmias to have their cardioversion more urgently as it may help to improve myocardial injury.