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Sudden Cardiac Arrest: ECG Repolarization After Resuscitation
Author(s) -
LELLOUCHE NICOLAS,
SACHER FREDERIC,
JORROT PIERRE,
CARIOU ALAIN,
SPAULDING CHRISTIAN,
AURORE AMANDINE,
COMBES XAVIER,
FICHET JEROME,
TEIGER EMMANUEL,
JAIS PIERRE,
DUBOISRANDÉ JEANLUC,
HAISSAGUERRE MICHEL
Publication year - 2011
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2010.01871.x
Subject(s) - medicine , benign early repolarization , cardiology , myocardial infarction , st segment , cardiopulmonary resuscitation , resuscitation , sudden cardiac arrest , electrocardiography , st elevation , context (archaeology) , repolarization , acute coronary syndrome , sudden cardiac death , anesthesia , paleontology , electrophysiology , biology
Sudden Cardiac Arrest and ECG Repolarization. Introduction: Early repolarization (ERep) abnormalities on electrocardiogram (ECG) are common immediately following cardiac arrest. We characterized and correlated electrocardiographic repolarization abnormalities immediately after cardiac arrest with acute coronary angiography. Methods and Results: We studied 225 consecutive patients presenting with out‐of‐hospital cardiac arrest. All these patients had successful cardiopulmonary resuscitation and acute coronary angiography. The first ECG recorded after successful resuscitation was analyzed by two independent cardiologists. Patients were categorized according to their repolarization pattern.Pattern 1: No ST segment elevation or ERep. Pattern 2: ST segment elevation without ERep. Pattern 3: ST segment elevation and ERep. Pattern 4: ERep only.Patterns 1, 2, 3, and 4 were found in 112 (50%), 74 (33%), 19 (8%), and 20 (9%) patients, respectively. Cardiac arrest was due to acute myocardial ischemia in 45%, 82%, 39%, and 15% of patients in groups 1, 2, 3 and 4, respectively (P < 0.0001). Sensitivity and specificity of pattern 2 was 50% and 88%, respectively, for acute coronary lesion, whereas isolated ERep pattern occurred in 9% of cases and was associated with a nonischemic event (80%). Among 65 patients (29%) who survived, 7% of patients with pattern 1, 13% with pattern 2, 60% with pattern 3, and 88% with pattern 4 exhibited ERep on ECG during the follow‐up.Conclusion:In the context of cardiac resuscitation, an ECG with ST elevation favors acute myocardial infarction, whereas the presence of ERep is a marker of a nonischemic event and future ERep syndrome. (J Cardiovasc Electrophysiol, Vol. 22, pp. 131‐136, February 2011)