Key result
Human QRS/QTc values from hypothermic patients correlated perfectly (correlation coefficient 1.00) with rabbit ventricular fibrillation thresholds, indicating its potential as a biomarker for hypothermia-induced cardiac arrest.
Why the study?
Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging, and an ECG biomarker is needed to predict ventricular arrhythmias across hypothermic temperatures.
Does the QRS/QTc ratio predict the risk of ventricular fibrillation in hypothermic patients?
Does the QRS/QTc ratio predict the risk of ventricular fibrillation in hypothermic patients?
Effect estimate: correlation coefficient 1.00
The QRS/QTc ratio is a promising novel ECG biomarker that correlates highly with the risk of ventricular fibrillation during hypothermia.
May inform VF risk stratification in hypothermia; leaves open prospective validation before clinical adoption.
BACKGROUND: Treatment of arrhythmias evoked by accidental or therapeutic hypothermia and rewarming remains challenging. We aim to find an ECG-biomarker that can predict ventricular arrhythmias at temperatures occurring in therapeutic and accidental hypothermia. MAIN BODY: Evaluation of ECG-data from accidental and therapeutic hypothermia patients and experimental data on ECG and ventricular fibrillation (VF) threshold in hypothermic New Zealand White Rabbits. VF threshold was measured in rabbit hearts cooled to moderate (31 °C) and severe (17 °C) hypothermia. QRS-interval divided by corrected QT-interval (QTc) was calculated at same temperatures. Clinical QRS/QTc data were obtained after a systematic literature review. Rabbit QRS/QTc values correlated with risk for VF (correlation coefficient: 0.97). Human QRS/QTc values from hypothermic patients, showed similar correlation with risk for ventricular fibrillation in the experimental data (correlation coefficient: 1.00). CONCLUSIONS: These calculations indicate that QRS/QTc has potential as novel biomarker for predicting risk of hypothermia-induced cardiac arrest. Our findings apply both to victims of accidental hypothermia and to patients undergoing therapeutic hypothermia during surgery or after e.g. cardiac arrest.
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Dietrichs et al. (2020) studied Accidental and therapeutic hypothermia (n=831). QRS/QTc ratio was evaluated on Correlation between human QRS/QTc values and rabbit ventricular fibrillation threshold (correlation coefficient 1.00). Human QRS/QTc values from hypothermic patients correlated perfectly (correlation coefficient 1.00) with rabbit ventricular fibrillation thresholds, indicating its potential as a biomarker for hypothermia-induced cardiac arrest.
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