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Clinical Significance of J Waves in Patients Undergoing Therapeutic Hypothermia for Out‐of‐Hospital Cardiac Arrest
Author(s) -
HARHASH AHMED,
GUSSAK IHOR,
CASSUTO JAMES,
WINTERS STEPHEN L.
Publication year - 2017
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12988
Subject(s) - medicine , hypothermia , logistic regression , cardiology , incidence (geometry) , hazard ratio , confidence interval , physics , optics
Background Hypothermia is associated with the development of J waves. However, little is known about the impact of these electrocardiogram (ECG) findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) postresuscitation from out‐of‐hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in‐hospital mortality for patients with and without J waves either at baseline, during TH, or both. Methods We conducted a retrospective analysis of patients who suffered OHCA and underwent TH (goal temperature of 32–34°C). Fifty‐nine patients were stratified dependent upon the presence of or the development of J waves on surface ECGs. Descriptive analysis and logistic regression modeling were used to assess the population differences and mortality, respectively, between patients who developed J waves during TH and those who did not. Results There was no difference in the development of in‐hospital atrial or ventricular arrhythmias between patients with J waves present during TH (16%) and those without (17.6%, P = 0.834). Compared to patients without J waves at baseline and during TH, those with J waves present both at baseline and during TH had significantly worse survival (hazard ratio = 12.42, P = 0.046). Conclusions While J waves are common ECG findings during TH in patients resuscitated from OHCA, our study demonstrated an increase in mortality for patients with J waves present both at baseline and during TH.