Hypothermia ECG manifestations

Remember hyppthermia slows everything down ! Depolarization and repolarization of the heart also slows down in hypothermia, therefore explaining a lot of ECG changes.

IGURE 1 | Temporal correlation between action potential duration and the QT interval on the surface ECG.
FROM THE FOLLOWING ARTICLE:
The impact of drug-induced QT interval prolongation on drug discovery and development
Bernard Fermini & Anthony A. Fossa
Nature Reviews Drug Discovery 2, 439-447 (June 2003)
doi:10.1038/nrd1108

The impact of drug-induced QT interval prolongation on drug discovery and development

Mild hypothermia (32-35 celcius)

  • Prolongation of all intervals (PR, RR and QT)
  • Sinus bradycardia, varying degrees of AV block, idioventricular junctional rhythm

Moderate hypothermia (30-32 celcius)

  • Osbourne wave becomes apparent
  • Due to bradycardia, ectopic atrial foci start to discharge, eventually leading to Atrial Fibrillation with slow ventricular response.

Severe hypothermia (<30 celcius)

  • Progressive QRS widening can predispose to Ventricular fibrillation.
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