Cardiac repolarization after out-of-hospital cardiac arrest

Cardiac repolarization and prognostic implications during and after cooling in comatose survivors after out-of-hospital cardiac arrest.

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Out- of- hospital cardiac arrest is the most severe medical condition and the few who survive risk permanent brain damage. Some patients will be in a state of coma after resuscitation and for these patients current guidelines prescribe that cooling can improve survival and neurological function. The cooling is carried out with special cooling plates directly on the skin and sustained for 24 hours, after which the patient is slowly brought back to normal body temperature.

This might improve the chance of the patient returning to a life closer to normal afterwards. The cooling, also known as ‘therapeutic hypothermia’ is associated with complications in more than 1/3 of the patients, some of these being changes in the electrophysiological activity of the heart and thereby the risk of arrhythmia. The intervals in the electrophysiological activity and the pace of the heart sometimes change dramatically during cooling. These changes may predict whether the patient will develop life-threatening arrhythmia during cooling, and may predict the level of the remaining brain functioning when the patient hopefully wakes up from coma.

This project is established in an interregional collaboration in the Öresund Region, with the overall goal to improve the treatment of cardiac arrest by hopefully increasing survival- and the quality of life in survivors of cardiac arrest. The project is built on knowledge exchange and a coordinated collection of data, which makes us able to analyse electrocardiograms from almost 950 patients revived after cardiac arrest. By detailed analysis of more than 22 million heartbeats, it is possible to find out whether the electrophysiological changes during cooling can predict deadly arrhythmia. This may improve the treatment of cardiac arrest and will hopefully lead to improved survival.

The project is part of a Ph.D.-study and the establishment of the Centre for Cardiac arrest in the Öresund region (financed by the European Fund for Regional Development through the Interreg IV A Öresund-Kattegat-Skagerrak programme). The purpose of the Centre for Cardiac arrest is to increase knowledge on cardiac arrest through systematic and formalised research collaboration in the Öresund.


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