Increased QT Dispersion Is Linked to Worse Outcomes in Patients Hospitalized for Out‐of‐Hospital Cardiac Arrest
Open Access
- 18 August 2020
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Heart Association
- Vol. 9 (16)
- https://doi.org/10.1161/jaha.120.016485
Abstract
Background The incidence and mortality of out‐of‐hospital cardiac arrest (OHCA) remains high, but predicting outcomes is challenging. Being able to better assess prognosis of hospitalized patients after return of spontaneous circulation would enable improved management of survival expectations. In this study, we assessed the predictive value of ECG indexes in hospitalized patients with OHCA. Methods and Results PR interval and QT interval corrected by the Bazett formula (QTc) for all leads were calculated from standard 12‐lead ECGs 24 hours after return of spontaneous circulation in 93 patients who were hospitalized following OHCA. PR interval and QT and QTc duration did not differentiate OHCA survivors and nonsurvivors. However, QT and QTc dispersion was significantly increased in patients who died during hospitalization compared with survivors discharged from the hospital (PPP<0.001; likelihood ratio, 51.42). There was also significant correlation between dispersion measures and serum potassium at the time of measurement and between dispersion measures and cumulative epinephrine administration. No difference existed regarding the number of measurable leads. Conclusions Lesser QT and QTc dispersion at 24 hours after return of spontaneous circulation was significantly associated with survival and neurologic status at discharge. Routine evaluation of QT and QTc dispersion during hospitalization following return of spontaneous circulation might improve outcome prognostication for patients hospitalized for OHCA.This publication has 44 references indexed in Scilit:
- Ictal Modulation of Cardiac Repolarization, but Not of Heart Rate, Is Lateralized in Mesial Temporal Lobe EpilepsyPLOS ONE, 2013
- Lengthening of corrected QT during epileptic seizuresEpilepsia, 2010
- Sympathetic Sprouting Drives Hippocampal Cholinergic Reinnervation That Prevents Loss of a Muscarinic Receptor-Dependent Long-Term Depression at CA3–CA1 SynapsesJournal of Neuroscience, 2006
- Serum Neuron-Specific Enolase and S-100B Protein in Cardiac Arrest Patients Treated With HypothermiaStroke, 2003
- Changes in the corrected QT interval and corrected QT dispersion during haemodialysisHeart, 2002
- Dynamics of QT dispersion during myocardial infarction and ischaemiaInternational Journal of Cardiology, 1996
- QT dispersion and components of the QT interval in ischaemia and infarction.Heart, 1995
- Changes of circadian blood pressure patterns after hemodynamic and thromboembolic brain infarction.Stroke, 1994
- The effects of acute and chronic ingestion of ethanol on the autonomic nervous systemDrug and Alcohol Dependence, 1986
- ASSESSMENT OF OUTCOME AFTER SEVERE BRAIN DAMAGE A Practical ScaleThe Lancet, 1975