Key result
First post-resuscitation ECG findings, such as atrial fibrillation/flutter (HR 2.29; 95% CI 1.17-4.49; p=0.015), were significantly associated with increased 30-day mortality after OHCA due to MI.
Why the study?
The prognostic importance of the first electrocardiogram after return of spontaneous circulation in out-of-hospital cardiac arrest due to myocardial infarction had been much less studied than prehospital resuscitation efforts.
Do specific electrocardiographic findings on the first ECG after ROSC predict 30-day mortality in patients with OHCA due to MI?
Cohort (n=119)
Do specific electrocardiographic findings on the first ECG after ROSC predict 30-day mortality in patients with OHCA due to MI?
Hazard Ratio: 2.29 (95% CI 1.17–4.49)
p-value: p=0.015
Specific ECG abnormalities, including conduction blocks and repolarization abnormalities, on the first post-ROSC ECG are associated with increased 30-day mortality in patients with OHCA due to MI.
Post-ROSC ECG markers may refine early risk stratification after MI-related OHCA; leaves open their therapeutic role pending prospective validation.
BACKGROUND: While there is substantial evidence on the impact of prehospital resuscitation efforts on survival after out-of-hospital cardiac arrest (OHCA), the importance of the first electrocardiogram after return of spontaneous circulation has been much less studied. OBJECTIVES: The aim of this study was to identify prognostically relevant electrocardiographic findings in patients after OHCA due to myocardial infarction (MI). METHODS: A total of 119 patients admitted to hospital after suffering an OHCA due to MI were retrospectively analyzed. Patient characteristics and the first 12-lead electrocardiogram after return of spontaneous circulation were collected. The primary outcome was 30-day mortality. RESULTS: A number of electrocardiographic findings were significantly associated with 30-day mortality: atrial fibrillation/flutter (HR 2.29 [95% CI 1.17-4.49, p = 0.015]), right bundle branch block (HR 2.23 [95% CI 1.14-4.56, p = 0.020]), bifascicular block (HR 2.51 [95% CI 1.04-6.059, p = 0.040]), T inversion (HR 2.01 [95% CI 1.02-3.99, p = 0.043]), QTc duration ≥500 ms (HR 2.21 [95% CI 1.10-4.42, p = 0.025]) and QT dispersion ≥ 100 ms (HR 2.11 [95% CI 1.02-4.37, p = 0.045]). CONCLUSION: Several different electrocardiographic findings are associated with increased mortality in patients with OHCA due to MI.
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Martens et al. (2024) conducted a cohort in Out-of-hospital cardiac arrest due to myocardial infarction (n=119). Atrial fibrillation/flutter on first post-resuscitation electrocardiogram vs. Absence of atrial fibrillation/flutter was evaluated on 30-day mortality (HR 2.29, 95% CI 1.17-4.49, p=0.015). First post-resuscitation ECG findings, such as atrial fibrillation/flutter (HR 2.29; 95% CI 1.17-4.49; p=0.015), were significantly associated with increased 30-day mortality after OHCA due to MI.
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