Key result
Osborn waves during therapeutic hypothermia linked to ~7-fold more appropriate ICD shocks in SCA survivors.
Why the study?
The study investigated the impact of Osborn waves during therapeutic hypothermia on the recurrence of future fatal arrhythmias in patients resuscitated after sudden cardiac arrest.
Does the presence of Osborn waves during therapeutic hypothermia predict the recurrence of fatal arrhythmias in patients resuscitated after sudden cardiac arrest?
Cohort (n=100)
Does the presence of Osborn waves during therapeutic hypothermia predict the recurrence of fatal arrhythmias in patients resuscitated after sudden cardiac arrest?
Absolute Event Rate: 43% vs 6%
p-value: p=0.032
The presence of Osborn waves during therapeutic hypothermia in sudden cardiac arrest survivors is associated with a higher long-term risk of recurrent fatal arrhythmias requiring ICD shocks.
Osborn waves may flag higher arrhythmia recurrence risk after arrest; leaves open their utility for risk stratification pending prospective validation.
BACKGROUND: This study investigates the impact of the occurrence of Osborn waves during therapeutic hypothermia (TH) on the recurrence of future fatal arrhythmias in patients resuscitated after sudden cardiac arrest (SCA). METHODS: Of all survivors of out-of-hospital SCA, 100 consecutive patients (mean age, 52 ± 15 years; 80% men) who received TH were included in this study. RESULTS: The most common first documented arrhythmia was ventricular fibrillation (VF) (77%), and ischemic heart disease (44%) and idiopathic VF (22%) were the most common causes of SCA in resuscitated patients. During TH, Osborn waves developed in 29 patients (29%). Osborn waves occurred more frequently in patients with Brugada syndrome. Patients with Osborn waves had lower in-hospital (10.3% vs 26.8%; P = .072) and 1-year death rates (20.7% vs 39.4%; P = .073) and better cerebral function (cerebral performance category scale, 2.0 ± 1.5 vs 2.7 ± 1.8; P = .053) than those without Osborn waves, although there was no statistical significance. Among 78 in-hospital survivors, 31 (40%) underwent implantable cardioverter-defibrillator (ICD) implantation. Appropriate ICD shocks from fatal arrhythmias were more frequent in patients who had Osborn waves than in those without Osborn waves (43% vs 6%; P = .032). CONCLUSIONS: Osborn waves during TH had no significant effect on the survival and cerebral function of patients resuscitated SCA. However, appropriate ICD shocks due to the recurrence of VF were more frequent in patients with Osborn waves during long-term follow-up.
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Park et al. (2020) conducted a cohort in Sudden cardiac arrest (SCA) (n=100). Presence of Osborn waves during therapeutic hypothermia vs. Absence of Osborn waves was evaluated on Appropriate ICD shocks from fatal arrhythmias (p=0.032). The presence of Osborn waves during therapeutic hypothermia in sudden cardiac arrest survivors was associated with a higher rate of appropriate ICD shocks (43% vs 6%; P=0.032).
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