Rolfast et al listed common electrocardiographic changes seen in patients undergoing therapeutic hypothermia. The authors are from VU Medical Center in Amsterdam, The Netherlandss.
Patient selection: therapeutic hypothermia (temperature < 35°C), typically mild (32 to 33°C), to reduce neurological damage after cardiac arrest
Common ECG changes:
(1) presence of the Osborn wave (notch in the downstroke of the S wave at the J point)
(2) prolongation of the QTc
(3) atrial fibrillation
(4) ST segment elevation with the absence of reciprocal ST depression (pseudoinfarction)
(5) reduction in heart rate (bradycardia to low normal)
where:
• A patient with true myocardial infarction infarction will show ST depression in reciprocal leads to those showing ST segment elevation.
Hypothermia-related ECG changes typically disappear with rewarming.
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