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A-V block in accidental hypothermia

A I Jacob, E Lichstein, S D Ulano

    Journal of Electrocardiology
    |October 1, 1978
    PubMed

    Insights

    Accidental hypothermia can cause significant heart rhythm abnormalities, including absent P waves and prominent J waves on electrocardiograms (ECGs). These specific cardiac conduction issues, identified via His bundle electrocardiography, resolved upon patient rewarming.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Internal Medicine

    Background:

    • Accidental hypothermia poses significant risks to cardiovascular function.
    • Standard electrocardiography (ECG) may reveal subtle or overt cardiac abnormalities during hypothermia.

    Observation:

    • A patient experiencing accidental hypothermia presented with specific ECG findings: absent P waves, prominent J waves, and an irregular rhythm.
    • His bundle electrocardiography was utilized to further investigate the cardiac conduction disturbances.

    Findings:

    • His bundle electrocardiography revealed sino-ventricular conduction, indicating an unusual pathway of electrical signal transmission.
    • A prolonged AH interval, a measure of atrioventricular nodal conduction time, was observed and did not respond to atropine administration.
    • These electrophysiological abnormalities were transient and fully reversed upon successful rewarming of the patient.

    Implications:

    • This case highlights the importance of His bundle electrocardiography in diagnosing complex cardiac arrhythmias associated with hypothermia.
    • Understanding these specific conduction abnormalities can aid in the clinical management of hypothermic patients.
    • The reversible nature of these findings underscores the critical role of timely and effective rewarming protocols.

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