Clinical Significance of J Waves in Patients Undergoing Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest

Ahmed Harhash, Ihor Gussak, James Cassuto, Stephen L. Winters

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Hypothermia is associated with the development of J waves. However, little is known about the impact of these electrocardiogram (ECG) findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) postresuscitation from out-of-hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in-hospital mortality for patients with and without J waves either at baseline, during TH, or both. Methods: We conducted a retrospective analysis of patients who suffered OHCA and underwent TH (goal temperature of 32–34°C). Fifty-nine patients were stratified dependent upon the presence of or the development of J waves on surface ECGs. Descriptive analysis and logistic regression modeling were used to assess the population differences and mortality, respectively, between patients who developed J waves during TH and those who did not. Results: There was no difference in the development of in-hospital atrial or ventricular arrhythmias between patients with J waves present during TH (16%) and those without (17.6%, P = 0.834). Compared to patients without J waves at baseline and during TH, those with J waves present both at baseline and during TH had significantly worse survival (hazard ratio = 12.42, P = 0.046). Conclusions: While J waves are common ECG findings during TH in patients resuscitated from OHCA, our study demonstrated an increase in mortality for patients with J waves present both at baseline and during TH.

Original languageEnglish (US)
Pages (from-to)154-161
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume40
Issue number2
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

Fingerprint

Out-of-Hospital Cardiac Arrest
Induced Hypothermia
Cardiac Arrhythmias
Electrocardiography
Mortality
Hospital Mortality
Hypothermia
Logistic Models

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{8100b04f52244fe2b11fe1a7e23103bd,
title = "Clinical Significance of J Waves in Patients Undergoing Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest",
abstract = "Background: Hypothermia is associated with the development of J waves. However, little is known about the impact of these electrocardiogram (ECG) findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) postresuscitation from out-of-hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in-hospital mortality for patients with and without J waves either at baseline, during TH, or both. Methods: We conducted a retrospective analysis of patients who suffered OHCA and underwent TH (goal temperature of 32–34°C). Fifty-nine patients were stratified dependent upon the presence of or the development of J waves on surface ECGs. Descriptive analysis and logistic regression modeling were used to assess the population differences and mortality, respectively, between patients who developed J waves during TH and those who did not. Results: There was no difference in the development of in-hospital atrial or ventricular arrhythmias between patients with J waves present during TH (16{\%}) and those without (17.6{\%}, P = 0.834). Compared to patients without J waves at baseline and during TH, those with J waves present both at baseline and during TH had significantly worse survival (hazard ratio = 12.42, P = 0.046). Conclusions: While J waves are common ECG findings during TH in patients resuscitated from OHCA, our study demonstrated an increase in mortality for patients with J waves present both at baseline and during TH.",
author = "Ahmed Harhash and Ihor Gussak and James Cassuto and Winters, {Stephen L.}",
year = "2017",
month = "2",
day = "1",
doi = "10.1111/pace.12988",
language = "English (US)",
volume = "40",
pages = "154--161",
journal = "PACE - Pacing and Clinical Electrophysiology",
issn = "0147-8389",
publisher = "Wiley-Blackwell",
number = "2",

}

Clinical Significance of J Waves in Patients Undergoing Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest. / Harhash, Ahmed; Gussak, Ihor; Cassuto, James; Winters, Stephen L.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 40, No. 2, 01.02.2017, p. 154-161.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical Significance of J Waves in Patients Undergoing Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest

AU - Harhash, Ahmed

AU - Gussak, Ihor

AU - Cassuto, James

AU - Winters, Stephen L.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Hypothermia is associated with the development of J waves. However, little is known about the impact of these electrocardiogram (ECG) findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) postresuscitation from out-of-hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in-hospital mortality for patients with and without J waves either at baseline, during TH, or both. Methods: We conducted a retrospective analysis of patients who suffered OHCA and underwent TH (goal temperature of 32–34°C). Fifty-nine patients were stratified dependent upon the presence of or the development of J waves on surface ECGs. Descriptive analysis and logistic regression modeling were used to assess the population differences and mortality, respectively, between patients who developed J waves during TH and those who did not. Results: There was no difference in the development of in-hospital atrial or ventricular arrhythmias between patients with J waves present during TH (16%) and those without (17.6%, P = 0.834). Compared to patients without J waves at baseline and during TH, those with J waves present both at baseline and during TH had significantly worse survival (hazard ratio = 12.42, P = 0.046). Conclusions: While J waves are common ECG findings during TH in patients resuscitated from OHCA, our study demonstrated an increase in mortality for patients with J waves present both at baseline and during TH.

AB - Background: Hypothermia is associated with the development of J waves. However, little is known about the impact of these electrocardiogram (ECG) findings on the development of ventricular arrhythmias and patient outcomes during therapeutic hypothermia (TH) postresuscitation from out-of-hospital cardiac arrest (OHCA). We investigated the prevalence of J waves in OHCA patients prior to and during TH. Additionally, we explored the incidence of atrial and ventricular arrhythmias and in-hospital mortality for patients with and without J waves either at baseline, during TH, or both. Methods: We conducted a retrospective analysis of patients who suffered OHCA and underwent TH (goal temperature of 32–34°C). Fifty-nine patients were stratified dependent upon the presence of or the development of J waves on surface ECGs. Descriptive analysis and logistic regression modeling were used to assess the population differences and mortality, respectively, between patients who developed J waves during TH and those who did not. Results: There was no difference in the development of in-hospital atrial or ventricular arrhythmias between patients with J waves present during TH (16%) and those without (17.6%, P = 0.834). Compared to patients without J waves at baseline and during TH, those with J waves present both at baseline and during TH had significantly worse survival (hazard ratio = 12.42, P = 0.046). Conclusions: While J waves are common ECG findings during TH in patients resuscitated from OHCA, our study demonstrated an increase in mortality for patients with J waves present both at baseline and during TH.

UR - http://www.scopus.com/inward/record.url?scp=85011672037&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011672037&partnerID=8YFLogxK

U2 - 10.1111/pace.12988

DO - 10.1111/pace.12988

M3 - Article

C2 - 27943347

AN - SCOPUS:85011672037

VL - 40

SP - 154

EP - 161

JO - PACE - Pacing and Clinical Electrophysiology

JF - PACE - Pacing and Clinical Electrophysiology

SN - 0147-8389

IS - 2

ER -