병원 밖 심정지 환자의 자발 순환 회복 직후의 심전도 소견과 관상동맥 조영술 결과의연관성 (The Relationship between the Postreturn of Spontaneous Circulation Electrocardiogram and Coronary Angiography Finding in out-of-Hospital Cardiac Arrest Patients)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 25권 / 5호 / 582 ~ 588페이지
· 저자명 : 이정훈, 최민정, 이태림, 차원철, 신태건, 조익준, 송근정, 이중의, 정연권, 심민섭

초록

Purpose: Coronary artery disease is the most commoncause 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 betweenECG findings and results of CAG of patients with return ofspontaneous circulation after OHCA.
Methods: We collected data from January 2010 until April2014. CAG was performed in patients with ROSC afterOHCA in whom ST-elevation or left bundle branch block(LBBB) was detected on ECG. If ECG showed anotherrhythm and no obvious non-cardiac cause of cardiac arrest,CAG was performed as an agreement between the emergencyphysician and cardiologist following by SamsungMedical Center OHCA protocol.
Results: CAG was performed in 75 patients among 131patients who were successfully resuscitated from OHCA.
We divided patients into two groups, ST-elevation or LBBBgroup and other group. Twenty nine patients in the ST-elevationor LBBB group had coronary lesion and nine patientsin the other group had coronary lesion on CAG (p<0.01); 15patients and five patients, respectively, had undergone PCI(p=0.02).
Conclusion: ECG findings of ST-elevation or LBBB werehighly associated with coronary lesions in successfullyresuscitated patients from OHCA. However, these ECGfindings were not an absolute indication for performing CAGbecause coronary artery lesions were also observed inpatients in the other group.

영어초록

Purpose: Coronary artery disease is the most commoncause 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 betweenECG findings and results of CAG of patients with return ofspontaneous circulation after OHCA.
Methods: We collected data from January 2010 until April2014. CAG was performed in patients with ROSC afterOHCA in whom ST-elevation or left bundle branch block(LBBB) was detected on ECG. If ECG showed anotherrhythm and no obvious non-cardiac cause of cardiac arrest,CAG was performed as an agreement between the emergencyphysician and cardiologist following by SamsungMedical Center OHCA protocol.
Results: CAG was performed in 75 patients among 131patients who were successfully resuscitated from OHCA.
We divided patients into two groups, ST-elevation or LBBBgroup and other group. Twenty nine patients in the ST-elevationor LBBB group had coronary lesion and nine patientsin the other group had coronary lesion on CAG (p<0.01); 15patients and five patients, respectively, had undergone PCI(p=0.02).
Conclusion: ECG findings of ST-elevation or LBBB werehighly associated with coronary lesions in successfullyresuscitated patients from OHCA. However, these ECGfindings were not an absolute indication for performing CAGbecause coronary artery lesions were also observed inpatients in the other group.

참고자료

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