Out-of-Hospital Cardiac Arrest 30-Day-Outcomes: The Importance of the First Electrocardiogram After Successful Resuscitation

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 1.174.49, p = 0.0151), right bundle branch block (HR 2.23 [95% CI 1.14-4.56, p = 0.0201), bifascicular block (HR 2.51 [95% CI 1.04-6.059, p = 0.0401), T inversion (HR 2.01 [95% CI 1.02-3.99, p = 0.0431), QTc duration >= 500 ms (HR 2.21 [95% CI 1.10-4.42, p = 0.0251) and QT dispersion >= 100 ms (HR 2.11 [95% CI 1.02-4.37, p = 0.0451). Conclusion: Several different electrocardiographic findings are associated with increased mortality in patients with OHCA due to MI. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/)