RT Journal Article
SR Electronic
T1 Associations between common ECG abnormalities and out-of-hospital cardiac arrest
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000905
DO 10.1136/openhrt-2018-000905
VO 6
IS 1
A1 Marc Meller Søndergaard
A1 Jonas Bille Nielsen
A1 Rikke Nørmark Mortensen
A1 Gunnar Gislason
A1 Lars Køber
A1 Freddy Lippert
A1 Claus Graff
A1 Stig Haunsø
A1 Jesper Hastrup Svendsen
A1 Kristian Hay Kragholm
A1 Adrian Holger Pietersen
A1 Bent Struer Lind
A1 Søren Pihlkjær Hjortshøj
A1 Anders Gaarsdal Holst
A1 Johannes Jan Struijk
A1 Christian Torp-Pedersen
A1 Steen Møller Hansen
YR 2019
UL http://openheart.bmj.com/content/6/1/e000905.abstract
AB Background Out-of-hospital cardiac arrest (OHCA) is often the first manifestation of unrecognised cardiac disease. ECG abnormalities encountered in primary care settings may be warning signs of OHCA.Objective We examined the association between common ECG abnormalities and OHCA in a primary care setting.Methods We cross-linked individuals who had an ECG recording between 2001 and 2011 in a primary care setting with the Danish Cardiac Arrest Registry and identified OHCAs of presumed cardiac cause.Results A total of 326 227 individuals were included and 2667 (0,8%) suffered an OHCA. In Cox regression analyses, adjusted for age and sex, the following ECG findings were strongly associated with OHCA: ST-depression without concomitant atrial fibrillation (HR 2.79; 95% CI 2.45 to 3.18), left bundle branch block (LBBB; HR 3.44; 95% CI 2.85 to 4.14) and non-specific intraventricular block (NSIB; HR 3.15; 95% CI 2.58 to 3.83). Also associated with OHCA were atrial fibrillation (HR 1.89; 95% CI 1.63 to 2.18), Q-wave (HR 1.75; 95% CI 1.57 to 1.95), Cornell and Sokolow-Lyon criteria for left ventricular hypertrophy (HR 1.56; 95% CI 1.33 to 1.82 and HR 1.27; 95% CI 1.12 to 1.45, respectively), ST-elevation (HR 1.40; 95% CI 1.09 to 1.54) and right bundle branch block (HR 1.29; 95% CI 1.09 to 1.54). The association between ST-depression and OHCA diminished with concomitant atrial fibrillation (HR 1.79; 95% CI 1.42 to 2.24, p < 0.01 for interaction). Among patients suffering from OHCA, without a known cardiac disease at the time of the cardiac arrest, 14.2 % had LBBB, NSIB or ST-depression.Conclusions Several common ECG findings obtained from a primary care setting are associated with OHCA.