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A56-year-old man presented with hypothermia (rectal temperature of 30.1°C) and hypotension after being found by emergency medical services (EMS) on his basement floor. A 12-lead electrocardiogram (ECG) revealed normal sinus rhythm with a rate of 62 bpm, right bundle branch block, prolonged QT interval (QTc of 564 ms), wide QRS (110 ms), and a promi...
Citations
Introduction:
Several reports illustrate an inverse correlation between the Osborn wave (J wave) amplitude and core body temperature. We attempted to study the strength of this correlation.
Methods:
We reviewed all articles reporting hypothermic J waves from 1950-2014 for patient demographics, core body temperature in Celsius (°C), amplitude of the J wave in millimeters (mm), lead with the highest amplitude of J wave, presence of acidosis, PO2, electrolytes and outcome. In cases with more than one electrocardiogram (ECG), the respective core body temperature and J wave amplitude of each ECG were recorded. The main study outcome is to evaluate the correlation between the J wave amplitude and core body temperature in the admission ECG. We have also examined the strength of this relationship in cases with more than one ECG. We attempted to find the most frequent lead that recorded the highest amplitude of the J wave in addition to the correlation between the amplitude of J wave and pH.
Results:
We found 64 articles comprising a total of 68 cases. When analyzing only cases with more than one reported ECG, there was a strong inverse correlation (r= - 0.682, p<0.001) between J wave amplitude and body temperature: however, when analyzing admission ECG of all cases, the correlation was only moderate (r= - 0.410, p<0.001). The lead with the highest amplitude of the J wave was V4 (44% of the cases, p<0.001) followed by V3 (23.7% of the cases, p<0.001).
Conclusion:
The amplitude of the J wave in the admission ECG of hypothermic patients may not accurately predict the core body temperature.
