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Late heartbeat-evoked potentials are associated with survival after cardiac arrest

André Schulz1, Pascal Stammet2, Angelika M Dierolf1

  • 1Clinical Psychophysiology Laboratory, Institute for Health and Behaviour, Research Unit INSIDE, University of Luxembourg, Esch-sur-Alzette, Luxembourg.

Resuscitation
|February 16, 2018
PubMed

Insights

Brain-heart communication, measured by heartbeat-evoked brain potentials (HEPs), is linked to survival after cardiac arrest (CA). Higher HEP amplitudes in survivors suggest this connection is crucial for recovery outcomes.

Area of Science:

  • Neuroscience
  • Cardiology
  • Critical Care Medicine

Background:

  • Cardiac arrest (CA) has high mortality, with neurological damage being a primary concern post-resuscitation.
  • The relationship between brain-heart communication and patient outcomes following CA remains largely unexplored.
  • Heartbeat-evoked brain potentials (HEPs) offer a quantifiable measure of neurophysiological brain-heart interaction.

Purpose of the Study:

  • To investigate the association between heartbeat-evoked brain potentials (HEPs) and 6-month survival rates in patients who experienced cardiac arrest.
  • To determine if HEP amplitude variations correlate with patient outcomes after successful resuscitation from CA.

Main Methods:

  • HEPs were assessed using resting electroencephalography (EEG) and electrocardiography (ECG) in 55 CA patients 24 hours post-resuscitation.
  • Patients underwent targeted temperature management and standardized sedation during HEP assessment.
  • The study analyzed the association between HEP amplitudes in specific time intervals (180-320 ms, 455-595 ms, 860-1000 ms) and 6-month survival.

Main Results:

  • Forty-five percent (25/55) of patients survived at the 6-month follow-up.
  • Survivors exhibited significantly higher HEP amplitudes at frontopolar and frontal electrodes during the late HEP interval compared to non-survivors.
  • These findings remained statistically significant after adjusting for age, fentanyl dosage, and time from resuscitation to EEG.

Conclusions:

  • The study demonstrates a significant association between brain-heart communication, as indicated by HEPs, and survival following cardiac arrest.
  • These results highlight the importance of the brain-heart axis in determining recovery and survival post-CA.
  • Further research is warranted to explore the clinical implications of the brain-heart axis in the context of cardiac arrest management.
Abstract

Keywords:
Brain-heart interactionCardiac arrestInteroceptionNeurological outcomePrognosticationSedationTargeted temperature managementVisceral-afferent signals

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