P1575The prognostic impact of electrocardiographic changes during therapeutic hypothermia in patients with resuscitated cardiac arrest

Abstract

Background: Therapeutic hypothermia improves survival and neurologic outcome in patients who resuscitated after cardiac arrest. Purpose(s): It is not well known about the prognostic impact of the change of electrocardiographic (ECG) parameters during therapeutic hypothermia. Method(s): Among patients who resuscitated after cardiac arrest from October 2012 to December 2014, Sixty six patients (mean age 52+/-17; 77% men) who performed therapeutic hypothermia were included. We compared precooling ECG parameters to ECG parameters during therapeutic hypothermia by using paired sample's 2 t-test. Result(s): There were 19 in-hospital deaths (29%) among overall patients who performed therapeutic hypothermia after resuscitated cardiac arrest. Half of the patients had ventricular fibrillation as the initial rhythm. During therapeutic hypothermia, heart rate decreased (111+/-31 versus 76+/-22, p<0.001) and corrected QT (QTc) interval increased (479+/-49 ms versus 512+/-55 ms, p<0.001). However there were no significant differences in PR and QRS intervals during therapeutic hypothermia. Osborn wave developed in 22 patients (33%). In patients with in-hospital death, precooling heart rate was faster (127+/-31 versus 105+/-29, p=0.009) and QTc interval (499+/-56 ms versus 471+/-44 ms, p=0.040) was more prolonged than those of in-hospital survivors. However the heart rate, Osborn wave, PR, QRS, and QTc intervals during therapeutic hypothermia did not affect the in-hospital mortality. Also there were no significant differences in change of ECG parameters between in-hospital survivors and nonsurvivors. Conclusion(s): Therapeutic hypothermia decreased heart rate and prolonged QTc interval. However the ECG changes during therapeutic hypothermia did not associated with in-hospital mortality. (Table Presented).