Hypothermia-induced Brugada-like electrocardiogram pattern

Area of Science:

• Cardiology
• Critical Care Medicine
• Clinical Electrophysiology

Background:

• Hypothermia is a potential complication following prolonged cardiopulmonary resuscitation (CPR).
• Electrocardiogram (ECG) abnormalities can occur during hypothermia.

Observation:

• A case study of a patient experiencing moderate hypothermia post-CPR is presented.
• The patient exhibited transient ECG changes, including prolonged QT interval and J waves.
• Specific ST-segment and T-wave abnormalities in leads V(1) and V(2) were observed, mimicking Brugada syndrome.

Findings:

• The observed ECG findings, such as downsloping ST-segment elevation and negative T waves in V(1)-V(2), are consistent with hypothermic effects.
• These transient changes can be mistaken for Brugada syndrome, a distinct genetic cardiac condition.
• The study discusses the potential physiopathologic mechanisms linking hypothermia to these specific ECG manifestations.

Implications:

• Recognizing hypothermia-induced ECG changes is crucial for accurate diagnosis and avoiding misdiagnosis of primary arrhythmias like Brugada syndrome.
• Understanding these mechanisms can aid in the management of post-CPR patients.
• This case highlights the importance of considering core body temperature when interpreting ECGs in critically ill patients.