Hypothermia: Atrial Fibrillation

Report:

Atrial fibrillation with ventricular response 70 – 96/min

Hypothermic humps (J waves, Osborn waves) and prolonged QTc suggestive of hypothermia[! XE "J wave" \t "See Hypothermia" !][! XE "Osborn wave" \t "See Hypothermia" !]

Nonspecific T wave changes

Comment:

The IVCD (QRS 0.14”) is entirely attributable to the hypothermic humps hugging terminal QRS in all the leads with tall R waves. The patient’s temperature was 34oC.

Atrial fibrillation is common in hypothermia, which “controls” the rate of ventricular response. Alcohol, of course, can induce it in its own right (the holiday heart) and is itself an important cause of hypothermia.

The patient was rewarmed in few hours and the ECG normalised except for still mildly prolonged QT interval (Fig 46a below).

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