Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study
Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult...
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| Autor*in: |
Tanguay, Alain [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2023 |
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© The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| Übergeordnetes Werk: |
Enthalten in: Canadian journal of emergency medicine - Berlin : Springer, 1999, 25(2023), 9 vom: 12. Aug., Seite 728-735 |
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| Übergeordnetes Werk: |
volume:25 ; year:2023 ; number:9 ; day:12 ; month:08 ; pages:728-735 |
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| DOI / URN: |
10.1007/s43678-023-00565-4 |
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| Katalog-ID: |
SPR053049330 |
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| 245 | 1 | 0 | |a Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study |
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| 520 | |a Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. | ||
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10.1007/s43678-023-00565-4 doi (DE-627)SPR053049330 (SPR)s43678-023-00565-4-e DE-627 ger DE-627 rakwb eng Tanguay, Alain verfasserin aut Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 Lebon, Johann (orcid)0000-0002-3226-3361 aut Hébert, Denise aut Enthalten in Canadian journal of emergency medicine Berlin : Springer, 1999 25(2023), 9 vom: 12. Aug., Seite 728-735 (DE-627)335259669 (DE-600)2059217-6 1481-8035 nnns volume:25 year:2023 number:9 day:12 month:08 pages:728-735 https://dx.doi.org/10.1007/s43678-023-00565-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 25 2023 9 12 08 728-735 |
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10.1007/s43678-023-00565-4 doi (DE-627)SPR053049330 (SPR)s43678-023-00565-4-e DE-627 ger DE-627 rakwb eng Tanguay, Alain verfasserin aut Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 Lebon, Johann (orcid)0000-0002-3226-3361 aut Hébert, Denise aut Enthalten in Canadian journal of emergency medicine Berlin : Springer, 1999 25(2023), 9 vom: 12. Aug., Seite 728-735 (DE-627)335259669 (DE-600)2059217-6 1481-8035 nnns volume:25 year:2023 number:9 day:12 month:08 pages:728-735 https://dx.doi.org/10.1007/s43678-023-00565-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 25 2023 9 12 08 728-735 |
| allfields_unstemmed |
10.1007/s43678-023-00565-4 doi (DE-627)SPR053049330 (SPR)s43678-023-00565-4-e DE-627 ger DE-627 rakwb eng Tanguay, Alain verfasserin aut Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 Lebon, Johann (orcid)0000-0002-3226-3361 aut Hébert, Denise aut Enthalten in Canadian journal of emergency medicine Berlin : Springer, 1999 25(2023), 9 vom: 12. Aug., Seite 728-735 (DE-627)335259669 (DE-600)2059217-6 1481-8035 nnns volume:25 year:2023 number:9 day:12 month:08 pages:728-735 https://dx.doi.org/10.1007/s43678-023-00565-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 25 2023 9 12 08 728-735 |
| allfieldsGer |
10.1007/s43678-023-00565-4 doi (DE-627)SPR053049330 (SPR)s43678-023-00565-4-e DE-627 ger DE-627 rakwb eng Tanguay, Alain verfasserin aut Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 Lebon, Johann (orcid)0000-0002-3226-3361 aut Hébert, Denise aut Enthalten in Canadian journal of emergency medicine Berlin : Springer, 1999 25(2023), 9 vom: 12. Aug., Seite 728-735 (DE-627)335259669 (DE-600)2059217-6 1481-8035 nnns volume:25 year:2023 number:9 day:12 month:08 pages:728-735 https://dx.doi.org/10.1007/s43678-023-00565-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 25 2023 9 12 08 728-735 |
| allfieldsSound |
10.1007/s43678-023-00565-4 doi (DE-627)SPR053049330 (SPR)s43678-023-00565-4-e DE-627 ger DE-627 rakwb eng Tanguay, Alain verfasserin aut Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 Lebon, Johann (orcid)0000-0002-3226-3361 aut Hébert, Denise aut Enthalten in Canadian journal of emergency medicine Berlin : Springer, 1999 25(2023), 9 vom: 12. Aug., Seite 728-735 (DE-627)335259669 (DE-600)2059217-6 1481-8035 nnns volume:25 year:2023 number:9 day:12 month:08 pages:728-735 https://dx.doi.org/10.1007/s43678-023-00565-4 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_121 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_165 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_374 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 AR 25 2023 9 12 08 728-735 |
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Enthalten in Canadian journal of emergency medicine 25(2023), 9 vom: 12. Aug., Seite 728-735 volume:25 year:2023 number:9 day:12 month:08 pages:728-735 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000naa a22002652 4500</leader><controlfield tag="001">SPR053049330</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230912064719.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230912s2023 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1007/s43678-023-00565-4</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)SPR053049330</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(SPR)s43678-023-00565-4-e</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Tanguay, Alain</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2023</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">Text</subfield><subfield code="b">txt</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="500" ind1=" " ind2=" "><subfield code="a">© The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Ventricular fibrillation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Predictors</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Risk Factors</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">ECG interpretation</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">STEMI</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">Prehospital</subfield><subfield code="7">(dpeaa)DE-He213</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Lebon, Johann</subfield><subfield code="0">(orcid)0000-0002-3226-3361</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Hébert, Denise</subfield><subfield code="4">aut</subfield></datafield><datafield tag="773" ind1="0" ind2="8"><subfield code="i">Enthalten in</subfield><subfield code="t">Canadian journal of emergency medicine</subfield><subfield code="d">Berlin : Springer, 1999</subfield><subfield code="g">25(2023), 9 vom: 12. 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Tanguay, Alain |
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Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study Ventricular fibrillation (dpeaa)DE-He213 Predictors (dpeaa)DE-He213 Risk Factors (dpeaa)DE-He213 ECG interpretation (dpeaa)DE-He213 STEMI (dpeaa)DE-He213 Prehospital (dpeaa)DE-He213 |
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Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study |
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early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected st-segment elevation myocardial infarction: a case–control study |
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Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study |
| abstract |
Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| abstractGer |
Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| abstract_unstemmed |
Purpose Our objective was to determine characteristics of electrocardiograms (ECG) that predict ventricular fibrillation (VF) among prehospital patients with suspected ST-segment elevation myocardial infarction (STEMI) in Québec. Methods We performed a matched case–control study of prehospital adult suspected with STEMI. Patients in case group (STEMI/VF+) were matched with controls (STEMI/VF–) for age and sex and then compared for ECG characteristics, including ST-segment elevations (STE) and depressions (STD), duration of interval complexes, general characteristics, and several calculated variables. Logistic regression was used to measure the association between ECG characteristics and VF development. Results Overall, 310 prehospital patients with suspected STEMI were included in the analysis (case group, n = 155; control group, n = 155). We confirmed that the presence of TW-pattern complex (OR 7.0, 95% CI 1.55–31.58), premature ventricular contraction (PVC) (OR 5.5, 95% CI 2.04–14.82), and STE in V2–V6 (OR 3.8, 95% CI 1.21–11.74) were electrocardiographic predictors of VF. We also observed that STD in V3–V5 (OR 6.5, 95% CI 1.42–29.39), atrial fibrillation (AF) ≥ 100 beats per minute (bpm) (OR 6.3, 95% CI 1.80–21.90), the combination of STE in V4 and V5, and STD in II, III and aVF (OR 4.8, 95% CI 1.01–22.35), and the presence of STD in ≥ 6 leads (OR 4.2, 95% CI 1.33–13.13) were also associated with VF development. Finally, simultaneous association of 2 (OR 2.3, 95% CI 1.13–4.06) and 3 (OR 11.6, 95% CI 3.22–41.66) predictors showed significant association with VF. Conclusions In addition to some already known predictors, we have identified several ECG findings associated with the development of VF in patients with suspected STEMI. Early identification of patients with STEMI at increased risk of VF should help EMS providers anticipate adverse events and encourage use of defibrillation pads. © The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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Early prediction of ventricular fibrillation using electrocardiographic characteristics in prehospital suspected ST-segment elevation myocardial infarction: a case–control study |
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https://dx.doi.org/10.1007/s43678-023-00565-4 |
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Lebon, Johann Hébert, Denise |
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| score |
7.401884 |