(Extract from "Principles of Clinical Electrocardiography". Mervin J. Goldman. 11th ed. 1982 p. 291)
Hypothermia induces EKG changes:
1) Sinus bradycardia
2) Junctional rhythm
3) Prolongation of QTc
With extreme degrees of cooling,...
1) Intraventricular conduction delay - causing notching of terminal portion of QRS (Osborn wave) followed by ST elevation
2) ST elevation
3) V. fib (when rectal temp falls below 28 degree C.
1) Kelly FE, Nolan JP. The effects of mild induced hypothermia on the myocardium: A systematic review. Anesthesia 2010 Feb 11 [Epub ahead of print]
2) Fink EL, Kochanek PM, Clark RS, Bell MJ. How I cool children in neurocritical care. Neurocrit care 2010 Feb 10 [Epub ahead of print]
3) Khan JN, Prasad N, Glancy JM. QTc prolongation during therapeutic hypothermia: are we giving it the attention it deserves? Europace 2010 Feb;12:266-70. [Epub 2009 Nov 30]
4) Fink EL, Clark RS, Kochanek PM, Bell MJ, Watson RS. A tertiary care center's experience with therapeutic hypothermia after pediatric cardiac arrest. Pediatr Crit Care Med 2010 Jan;11:66-74.
5) Tiainen M, Parikka HA, Makijarvi MA, Takkunen OS, Sarna SJ, Roine RO. Arrhythmias and heart rate variability during and after therapeutic hypothermia for cardiac arrest. Crit Care Med 2009 Feb;37:403-9
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