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Case of Recurrent Ventricular Fibrillations with Osborn Wave Developed during Therapeutic Hypothermia.

Kim CY, Bae MH, Kim NK, Yang YA, Kim KY, Lee JH, Eun JS, Cho Y - Korean Circ J (2015)

Bottom Line: Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient.The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored.This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.

ABSTRACT
Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient. Although Osborn wave is not pathognomonic of hypothermia, it is a well-known electrocardiogram finding of hypothermic patients. The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored. This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.

No MeSH data available.


Related in: MedlinePlus

Sequence of electrocardiogram (ECG) changes. A: initial ECG at our hospital shows sinus tachycardia. B: soon after therapeutic hypothermia started, Osborn waves appear in lead II and V 4-6 (arrows). C: recurrent ventricular fibrillation occurrs. D and E: as time went on, Osborn waves became prominent in diffuse leads and atrial fibrillation also appeared.
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Figure 2: Sequence of electrocardiogram (ECG) changes. A: initial ECG at our hospital shows sinus tachycardia. B: soon after therapeutic hypothermia started, Osborn waves appear in lead II and V 4-6 (arrows). C: recurrent ventricular fibrillation occurrs. D and E: as time went on, Osborn waves became prominent in diffuse leads and atrial fibrillation also appeared.

Mentions: At our hospital, initial ECG (Fig. 2A) showed sinus tachycardia with a heart rate of 114 beats per minute. On the first day of admission, echocardiography was done, which showed no regional wall motion abnormality of the left ventricle. The ejection fraction of left ventricle was 60%. Chest and brain computed tomography (CT) also did not reveal abnormality. The initial pH was 7.375 and the levels of electrolytes including sodium, potassium, calcium and magnesium were within the normal ranges.


Case of Recurrent Ventricular Fibrillations with Osborn Wave Developed during Therapeutic Hypothermia.

Kim CY, Bae MH, Kim NK, Yang YA, Kim KY, Lee JH, Eun JS, Cho Y - Korean Circ J (2015)

Sequence of electrocardiogram (ECG) changes. A: initial ECG at our hospital shows sinus tachycardia. B: soon after therapeutic hypothermia started, Osborn waves appear in lead II and V 4-6 (arrows). C: recurrent ventricular fibrillation occurrs. D and E: as time went on, Osborn waves became prominent in diffuse leads and atrial fibrillation also appeared.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4310985&req=5

Figure 2: Sequence of electrocardiogram (ECG) changes. A: initial ECG at our hospital shows sinus tachycardia. B: soon after therapeutic hypothermia started, Osborn waves appear in lead II and V 4-6 (arrows). C: recurrent ventricular fibrillation occurrs. D and E: as time went on, Osborn waves became prominent in diffuse leads and atrial fibrillation also appeared.
Mentions: At our hospital, initial ECG (Fig. 2A) showed sinus tachycardia with a heart rate of 114 beats per minute. On the first day of admission, echocardiography was done, which showed no regional wall motion abnormality of the left ventricle. The ejection fraction of left ventricle was 60%. Chest and brain computed tomography (CT) also did not reveal abnormality. The initial pH was 7.375 and the levels of electrolytes including sodium, potassium, calcium and magnesium were within the normal ranges.

Bottom Line: Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient.The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored.This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.

ABSTRACT
Therapeutic hypothermia (TH) has been used to protect neurological functions in cardiac arrest patient. Although Osborn wave is not pathognomonic of hypothermia, it is a well-known electrocardiogram finding of hypothermic patients. The cellular and ionic mechanisms of the Osborn wave have been suggested, and its relationship to tachyarrhythmias, such as ventricular tachycardia and ventricular fibrillation, is being explored. This case highlights the arrhythmogenic potential of Osborn wave and individual difference in response of TH.

No MeSH data available.


Related in: MedlinePlus