Key result
Osborn waves in hypothermia linked to ~4% incidence of ventricular fibrillation or tachycardia.
Why the study?
The relationship between Osborn wave presence in hypothermic patients and the development of fatal ventricular arrhythmias including VF and VT remains undetermined.
Cohort (n=464)
Yes
Absolute Event Rate: 4% vs 0%
p-value: p=0.003
May identify hypothermic patients needing closer arrhythmia monitoring; hypothesis-generating and should not yet change practice.
BACKGROUND: The Osborn wave (OW) is often observed in hypothermic patients; however, whether OW in hypothermic patients is related to the development of fatal ventricular arrhythmia, including ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT), remains undetermined. This study aimed to estimate the association between OW and the incidence of fatal ventricular arrhythmias. METHODS AND RESULTS: This retrospective study used the Japanese Accidental Hypothermia Network registry database and included 572 hypothermic patients. Patients were divided into the OW group (those with OW) and non-OW group (those without OW). The relationship between the development of fatal arrhythmias and presence of OW was assessed using the chi-squared test. All patients who developed VF/VT (n=10) had OW on electrocardiogram upon hospital arrival. The presence of OW had a sensitivity of 100%, specificity of 47.8%, positive predictive value of 4.0%, and negative predictive value of 100% for VF/VT development. The in-hospital mortality rate was 22.3% in the OW group and 21.2% in the non-OW group (P=0.781). CONCLUSIONS: OW was observed in all hypothermic patients with VF/VT. The occurrence of ventricular arrhythmias is highly unlikely in the absence of OW on the electrocardiogram. Although the presence of OW might be used to predict these fatal arrhythmias in hypothermic patients, there was no association between the presence of OW and in-hospital mortality.
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Okada et al. (2020) conducted a cohort in Accidental hypothermia (n=464). Osborn wave on electrocardiogram vs. Absence of Osborn wave was evaluated on Development of fatal arrhythmias (ventricular fibrillation or pulseless ventricular tachycardia) during rewarming (p=0.003). The presence of an Osborn wave on the electrocardiogram of hypothermic patients was associated with a 4.0% incidence of ventricular fibrillation or tachycardia, compared to 0% in patients without an Osborn wave (P=0.003).
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