Key result
Resuscitation after out-of-hospital cardiac arrest causes limited ECG changes, with no difference in STEMI criteria.
Why the study?
Global myocardial ischemia from cardiac arrest often causes post-arrest ECG abnormalities that can falsely mimic STEMI or mask signs of myocardial infarction, confounding analysis.
Does cardiac arrest and resuscitation induce significant 12-lead ECG changes that confound STEMI diagnosis in patients with EMS-witnessed OHCA?
Cohort (n=83)
No
Does cardiac arrest and resuscitation induce significant 12-lead ECG changes that confound STEMI diagnosis in patients with EMS-witnessed OHCA?
Absolute Event Rate: 61% vs 59%
p-value: p=0.83
In EMS-witnessed OHCA, ECG changes caused by resuscitation are limited, and post-ROSC 12-lead ECGs can be reliably used to evaluate the presence of STEMI.
Post-arrest ECGs may be confounded by global ischemia; leaves open reliable prehospital MI diagnosis in OHCA.
In out-of-hospital cardiac arrest (OHCA), the 12-lead ECG is often the only prehospital tool to establish the cause.1 However, global myocardial ischemia resulting from the cardiac arrest often renders the post-arrest ECG abnormal, confounding its analysis. ST-segment deviations might falsely mimic ST-segment elevation myocardial infarction (STEMI), while subtle signs of myocardial infarction may be masked.2 We assessed the extent of cardiac arrest-induced ECG changes by evaluating 12-lead ECG changes in emergency medical services (EMS)-witnessed OHCA patients by comparing prehospital pre-arrest and post-arrest ECGs.
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Verkaik et al. (2025) conducted a cohort in Out-of-hospital cardiac arrest (OHCA) (n=83). Cardiac arrest and resuscitation vs. Pre-arrest baseline (intra-patient comparison) was evaluated on Presence of STEMI criteria on ECG (p=0.83). In patients with EMS-witnessed out-of-hospital cardiac arrest, resuscitation caused limited ECG changes, with no significant difference in STEMI criteria between prearrest (59%) and postarrest (61%) ECGs.
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