Korean Circ J.  2015 Jan;45(1):81-84. 10.4070/kcj.2015.45.1.81.

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

Affiliations
  • 1Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. bmh0325@knu.ac.kr

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.

Keyword

Hypothermia; Electrocardiography; Ventricular fibrillation

MeSH Terms

Electrocardiography
Heart Arrest
Humans
Hypothermia*
Individuality
Tachycardia
Tachycardia, Ventricular
Ventricular Fibrillation*

Figure

  • Fig. 1 Initial electrocardiogram recorded by automated external defibrillator shows ventricular tachycardia.

  • Fig. 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.

  • Fig. 3 Changes after implantable cardioverter-defibrillator (ICD) insertion. A: after rewarming, the Osborn wave gradually disappears. B: an ICD is inserted.


Cited by  1 articles

Therapeutic Hypothermia for Cardioprotection in Acute Myocardial Infarction
In Sook Kang, Ikeno Fumiaki, Wook Bum Pyun
Yonsei Med J. 2016;57(2):291-297.    doi: 10.3349/ymj.2016.57.2.291.


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