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KMID : 1011920140150040004
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International Journal of Arrhythmia
2014 Volume.15 No. 4 p.4 ~ p.13
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Electrocardiographic Features of Therapeutic Hypothermia
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Lee Woo-Seok
Nam Gi-Byoung
Jo Uk
Choi Jin-Hee
Kwon Chang-Hee
Kim Yoo Ri
Choi Kee-Joon
Kim You-Ho
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Abstract
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Background & Objectives: It has been known that therapeutic hypothermia (TH) can induce electrocardiographic J waves. However, electrocardiographic features, clinical significance, and arrhythmogenic potentials of the J waves during TH remain unknown.
Subjects and Methods: We analyzed electrocardiograms from 68 patients, who underwent TH between August 2010 and August 2013. The frequency, amplitudes, distribution of the J waves, and the development of malignant arrhythmia (e.g. ventricular fibrillation [VF]) were analyzed.
Results: The average body temperature was 33.3±0.1 during hypothermia. 40 patients (58.8%) displayed J wave primarily in leads II, III, aVF, and leads V4-6. J waves were newly developed in 37 patients and preexisting J waves were augmented in three patients. The average amplitude of J waves was 0.20±0.01 mV. There were two events of VF during TH. These events occurred in patients finally diagnosed with Brugada syndrome and early repolarization syndrome (ERS). The maximum augmentation of the J waves in patients without electrical arrhythmic disorders was 0.35 mV. In two patients with ERS, J waves were markedly augmented during TH (mean 0.43±0.09 mV).
Conclusions: J waves are noted most frequently in the inferior or lateral precordial leads during TH. Two of 68 patients displayed life-threatening arrhythmias associated with J wave occurrence. Proarrhythmic potential of hypothermia in patients with preexisting ERS or Brugada pattern on the electrocardiogram requires further evaluation in future studies.
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KEYWORD
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therapeutic hypothermia, J wave
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