Rosol Zachary, Miranda David F, Sandoval Yader, Bart Bradley A, Smith Stephen W, Goldsmith Steven R
Department of Medicine, Hennepin County Medical Center, Minneapolis, MN, United States.
Division of Cardiology, Department of Medicine, Hennepin County Medical Center, Minneapolis, MN, United States.
J Crit Care. 2017 Jun;39:182-184. doi: 10.1016/j.jcrc.2017.02.030. Epub 2017 Feb 22.
Targeted Temperature Management (TTM) improves outcomes after cardiac arrest but may affect the QT and QTc intervals which could increase the chance of subsequent arrhythmia. We report here the effects of TTM on both computer-derived and manually calculated QT and QTc as well as the relationship of the length of the QTc and serious arrhythmia in a retrospective single-center experience.
193 patients undergoing TTM for cardiac arrest were studied. 12-lead electrocardiograms (ECG) were measured before, during and after TTM. We assessed the QT and Bazett-corrected QT intervals (QTc) and examined the relationship between QTc and the occurrence of malignant arrhythmias.
Both the QT and QTc increased during TTM whether derived manually or from the computer algorithm, although values were different with the two methods. Neither the QT nor the QTc were significantly longer in those patients with malignant arrhythmias.
QT and QTc prolong during TTM. There was no differential increase in the QTc in patients who experienced malignant arrhythmias. While the mechanism of QTc prolongation is not clear, it would not appear that the degree of QTc prolongation has an adverse effect on cardiac rhythm during TTM.
目标温度管理(TTM)可改善心脏骤停后的预后,但可能影响QT和QTc间期,这可能增加随后发生心律失常的几率。在此,我们报告在一项回顾性单中心研究中TTM对计算机推导和人工计算的QT及QTc的影响,以及QTc长度与严重心律失常之间的关系。
对193例接受心脏骤停TTM治疗的患者进行研究。在TTM治疗前、治疗期间和治疗后测量12导联心电图(ECG)。我们评估了QT和Bazett校正的QT间期(QTc),并研究了QTc与恶性心律失常发生之间的关系。
无论是人工推导还是通过计算机算法,在TTM治疗期间QT和QTc均增加,尽管两种方法得出的值有所不同。发生恶性心律失常的患者中,QT和QTc均未显著延长。
TTM期间QT和QTc延长。发生恶性心律失常的患者QTc没有差异增加。虽然QTc延长的机制尚不清楚,但在TTM期间,QTc延长的程度似乎对心律没有不利影响。