ECG features and proarrhythmic potentials of therapeutic hypothermia
Autor: | Guang-Won Seo, Ki-Hun Kim, Yong-Seog Oh, Jin Hee Choi, You-Ho Kim, Kyoung-Suk Rhee, Kyu Nam Park, Uk Jo, Jun Kim, Won Young Kim, Kee-Joon Choi, Yoo Ri Kim, Wooseok Lee, Eun-Sun Jin, Kiwon Hwang, Gi-Byoung Nam, Sung Hwan Kim, Chang Hee Kwon, Lae-Young Jung |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male medicine.medical_specialty Resuscitation Population Action Potentials Precordial examination 030204 cardiovascular system & hematology Hospitals University Electrocardiography 03 medical and health sciences 0302 clinical medicine Heart Conduction System Heart Rate Hypothermia Induced Predictive Value of Tests Risk Factors Internal medicine Republic of Korea medicine Humans Clinical significance 030212 general & internal medicine education Aged Brugada Syndrome Brugada syndrome Asphyxia education.field_of_study business.industry Middle Aged Hypothermia medicine.disease Heart Arrest Ventricular Fibrillation Ventricular fibrillation Cardiology Etiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Body Temperature Regulation |
Zdroj: | Heart. 102:1558-1565 |
ISSN: | 1468-201X 1355-6037 |
Popis: | Objective Hypothermia can induce ECG J waves. Recent studies suggest that J waves may be associated with ventricular fibrillation (VF) in patients with structurally normal hearts. However, little is known about the ECG features, clinical significance or arrhythmogenic potentials of therapeutic hypothermia (TH)-induced J waves. Methods We analysed ECGs from 240 patients who underwent TH at six major university hospitals in Korea between August 2010 and December 2013. The prevalence, amplitudes and distributions of the J waves and the development of malignant arrhythmia were analysed. Results The average patient body temperature was 33.5±1.0°C during TH. J waves were observed in 98 patients (40.8%). They were newly developed in 91 cases, and pre-existing J waves were augmented in seven patients. J waves during TH were primarily observed in leads II, III, aVF and V 4–6 . The average amplitude of the J waves was 0.239±0.152 mV. There were four VF events during TH. These events occurred in three patients who were finally diagnosed with Brugada syndrome, idiopathic VF or early repolarisation syndrome, respectively, and in one patient with non-cardiac aetiology (asphyxia). Conclusions J waves were recorded in about 40% of the patients who received TH. They were most frequently observed in the inferior limb leads or lateral precordial leads. Life-threatening VF occurred only rarely (1.7%) during TH and were mainly observed in patients with primary arrhythmic disorder. Although a causal relationship between TH-induced J waves and VF remains unknown, administering TH to this potentially susceptible, high-risk population may require careful attention. |
Databáze: | OpenAIRE |
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