Background: While there is substantial evidence on the impact of prehospital resuscitation efforts on survival after out-of-hospital cardiac arrest (OHCA), the importance of the first electrocardiogram after return of spontaneous circulation has been much less studied.
Objectives: The aim of this study was to identify prognostically relevant electrocardiographic findings in patients after OHCA due to myocardial infarction (MI).
Methods: A total of 119 patients admitted to hospital after suffering an OHCA due to MI were retrospectively analyzed. Patient characteristics and the first 12-lead electrocardiogram after return of spontaneous circulation were collected. The primary outcome was 30-day mortality.
Results: A number of electrocardiographic findings were significantly associated with 30-day mortality: atrial fibrillation/flutter (HR 2.29 [95% CI 1.17-4.49, p = 0.015]), right bundle branch block (HR 2.23 [95% CI 1.14-4.56, p = 0.020]), bifascicular block (HR 2.51 [95% CI 1.04-6.059, p = 0.040]), T inversion (HR 2.01 [95% CI 1.02-3.99, p = 0.043]), QTc duration ≥500 ms (HR 2.21 [95% CI 1.10-4.42, p = 0.025]) and QT dispersion ≥ 100 ms (HR 2.11 [95% CI 1.02-4.37, p = 0.045]).
Conclusion: Several different electrocardiographic findings are associated with increased mortality in patients with OHCA due to MI.
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