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Hypothermia induced alteration of repolarization - impact on acute and long-term outcome
von Ulmenstein, Sophie ;  Storm, Christian ;  Breuer, Thomas G. K. ;  Lask, Sebastian ;  Attanasio, Philipp ;  Mügge, Andreas ;  Wutzler, Alexander

HaupttitelHypothermia induced alteration of repolarization - impact on acute and long-term outcome
Titelzusatza prospective cohort study
Autorvon Ulmenstein, Sophie
AutorStorm, Christian
AutorBreuer, Thomas G. K.
AutorLask, Sebastian
AutorAttanasio, Philipp
AutorMügge, Andreas
AutorWutzler, Alexander
Seitenzahl5 Seiten
Freie Schlagwörterresuscitation council guidelines; therapeutic hypothermia; QTC prolongation; interval; tend; ECG
DDC610 Medizin und Gesundheit
Auch erschienen inScandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 25 (2017), Artikel Nr. 68
ZusammenfassungBackground
The effects of target temperature management (TTM) on the heart aren’t thoroughly studied yet. Several studies showed the prolongation of various ECG parameters including Tpeak-Tend-time under TTM. Our study’s goal is to evaluate the acute and long-term outcome of these prolongations.

Methods
In this study we included patients with successful resuscitation after cardiac arrest who were admitted to the Charité Virchow Klinikum Berlin or the Heart and Vascular Centre of the Ruhr University Bochum between February 2006 and July 2013 (Berlin) or May 2014 to November 2015 (Bochum). For analysis, one ECG during TTM was recorded after reaching the target temperature (33–34 °C) or in the first 6 h of TTM. If possible, another ECG was taken after TTM. The patients were being followed until February 2016.

Primary endpoint was ventricular arrhythmia during TTM, secondary endpoints were death and hospitalization due to cardiovascular diseases during follow-up.

Results
One hundred fifty-eight patients were successfully resuscitated in the study period of which 95 patients had usable data (e.g. ECGs without artifacts). During TTM significant changes for different parameters of ventricular de- and repolarization were noted: QRS (103.2 ± 23.7 vs. 95.3 ± 18.1; p = 0.003),QT (405.8 ± 76.4 vs. 373.8 ± 75.0; p = 0.01), QTc (474.9 ± 59.7 vs. 431.0 ± 56.8; p < 0.001), JT (302.8 ± 69.4 vs. 278.5 ± 75.2; p = 0.043), JTc (354.3 ± 60.2 vs. 318.7 ± 59.1; p = 0.001). 13.7% of the patients had ventricular arrhythmias during TTM, however these patients showed no difference regarding their ECG parameters in comparison to those were no ventricular arrhythmias occurred. We were able to follow 69 Patients over an average period of 35 ± 31 months. The 14 (21.5%) patients who died during the follow-up had significant prolongations of the TpTe-time in the ECGs without TTM (103.9 ± 47.2 vs. 75.8 ± 28.6; p = 0.023).

Conclusion
Our results show a significant prolongation of ventricular repolarization during TH. However, there was no significant difference between the ECG parameters of those who developed a ventricular arrhythmia and those who did not. The temporary prolongation of the repolarization during TTM seems to be less important for the prognosis of the patient. Whereas the prolongation of the repolarization in the basal ECG is associated with a higher mortality in our study.
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Fachbereich/EinrichtungMedizinische Fakultät Charité - Universitätsmedizin Berlin
Erscheinungsjahr2017
Dokumententyp/-SammlungenWissenschaftlicher Artikel
SpracheEnglisch
RechteCreative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License
Anmerkungen des AutorsDiese Artikel wurde in einer reinen Open-Access-Zeitschrift publiziert.
Erstellt am23.08.2017 - 08:32:42
Letzte Änderung23.08.2017 - 08:33:04
 
Statische URLhttp://edocs.fu-berlin.de/docs/receive/FUDOCS_document_000000027597
DOI10.1186/s13049-017-0417-6
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