The Relationship between the Postreturn of Spontaneous Circulation Electrocardiogram and Coronary Angiography Finding in out-of-Hospital Cardiac Arrest Patients

ABSTRACT

PURPOSE: Coronary artery disease is the most common cause of out-of-hospital cardiac arrest (OHCA). However, there are no definite indications of coronary angiography (CAG) followed by percutaneous coronary intervention (PCI) in patients with OHCA for diagnosis and treatment. The aim of this study was to determine correlation between ECG findings and results of CAG of patients with return of spontaneous circulation after OHCA. METHODS: We collected data from January 2010 until April 2014. CAG was performed in patients with ROSC after OHCA in whom ST-elevation or left bundle branch block (LBBB) was detected on ECG. If ECG showed another rhythm and no obvious non-cardiac cause of cardiac arrest, CAG was performed as an agreement between the emergency physician and cardiologist following by Samsung Medical Center OHCA protocol. RESULTS: CAG was performed in 75 patients among 131 patients who were successfully resuscitated from OHCA. We divided patients into two groups, ST-elevation or LBBB group and other group. Twenty nine patients in the ST-elevation or LBBB group had coronary lesion and nine patients in the other group had coronary lesion on CAG (p<0.01); 15 patients and five patients, respectively, had undergone PCI (p=0.02). CONCLUSION: ECG findings of ST-elevation or LBBB were highly associated with coronary lesions in successfully resuscitated patients from OHCA. However, these ECG findings were not an absolute indication for performing CAG because coronary artery lesions were also observed in patients in the other group.