Diagnostic Tests for Electrical Injury

Initial Assessment

A standard 12-lead ECG should be performed on all patients with electrical injury to detect potential cardiac abnormalities, as recommended by the European Society of Cardiology 1, 2
Cardiac biomarkers including troponin and CK/CK-MB should be measured to assess for myocardial injury in patients with electrical injury, according to the European Heart Journal 3
Complete blood count, serum electrolytes, renal function tests, and urinalysis should be performed to evaluate for systemic effects in patients with electrical injury 3

Echocardiography is recommended for all patients with suspected ventricular arrhythmias or structural heart disease following electrical injury, as recommended by the European Society of Cardiology 1, 2

Exercise testing with imaging is recommended for patients with suspected silent ischemia who have intermediate probability of coronary artery disease, according to the European Heart Journal 1, 2
Pharmacological stress testing with imaging should be used for patients unable to perform exercise testing, as recommended by the European Society of Cardiology 2
Coronary angiography should be considered in patients with life-threatening ventricular arrhythmias or survivors of sudden cardiac arrest with intermediate or greater probability of coronary artery disease, according to the European Heart Journal 2

Electrophysiological testing is recommended for diagnostic evaluation of patients with symptoms suggestive of ventricular tachyarrhythmias following electrical injury, as recommended by the European Heart Journal 2, 4
Electrophysiological testing can be useful in patients with syncope when bradyarrhythmias or tachyarrhythmias are suspected and non-invasive studies are inconclusive, according to the European Society of Cardiology 2, 4

Signal-averaged ECG may be considered for suspected arrhythmogenic cardiomyopathy, as recommended by the European Society of Cardiology, although the specific guideline society is not specified in this case, the recommendation is based on 5