Photo Credit: Eik Scott

The following is a summary of “Out-of-Hospital Cardiac Arrest 30-Day-Outcomes: The Importance of the First Electrocardiogram After Successful Resuscitation,” published in the April 2025 issue of Journal of Emergency Medicine by Martens et al. 

The impact of prehospital resuscitation on survival after out-of-hospital cardiac arrest (OHCA) had been well studied, while the role of the first electrocardiogram after the return of spontaneous circulation had received less attention.  

Researchers conducted a retrospective study to identify electrocardiographic findings associated with prognosis after OHCA due to myocardial infarction (MI).  

They analyzed 119 individuals admitted to the hospital after experiencing an OHCA due to MI. Data on individual characteristics and the first 12-lead electrocardiogram recorded after the return of spontaneous circulation were collected. The primary outcome estimated was mortality within 30 days.  

The results showed that several electrocardiographic findings were significantly linked to 30-day mortality. Atrial fibrillation or flutter was associated with a hazard ratio (HR) of 2.29 (95% CI 1.17–4.49, P = 0.015). Right bundle branch block had a HR of 2.23 (95% CI 1.14–4.56, P = 0.020), while bifascicular block showed a HR of 2.51 (95% CI 1.04–6.059, P = 0.040). T-wave inversion was linked to a HR of 2.01 (95% CI 1.02–3.99, P = 0.043). A QTc interval of 500 milliseconds or more had a HR of 2.21 (95% CI 1.10–4.42, P = 0.025), and QT dispersion of at least 100 milliseconds was associated with a HR of 2.11 (95% CI 1.02–4.37, P = 0.045).  

Investigators concluded that several different electrocardiographic findings had been linked with higher mortality in patients with OHCA due to MI. 

Source: jem-journal.com/article/S0736-4679(24)00317-2/fulltext