Which cardiovascular findings are characteristic of electrical injuries?

Updated: Mar 09, 2020
  • Author: Tracy A Cushing, MD, MPH, FACEP, FAWM; Chief Editor: Joe Alcock, MD, MS  more...
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Answer

Patients may present in asystole or ventricular fibrillation (VF) in addition to other arrhythmias. Sudden death due to VF is more common with low-voltage AC, whereas asystole is more often associated with high-voltage AC or DC. Ventricular fibrillation can be caused at voltages as low as 50-120 mA, which is lower than the typical household current. One series showed cardiac arrhythmias following 41% of low-voltage injuries. [11]

Electricity can also cause conduction abnormalities and direct trauma to cardiac muscle fibers. Survivors of electrical shock can experience subsequent arrhythmias, usually sinus tachycardia and premature ventricular contractions (PVCs). One study identified three cases of delayed ventricular arrhythmias up to 12 hours after the incident. [24] Other studies have shown no risk of delayed arrhythmias in patients with initially normal ECGs, both in low-voltage household exposures and after CEW exposure. [19, 20, 25, 26] One case report describes coronary artery dissection after electrical injury. [27] Long-term cardiac complications from electrical injury are rare.


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