ArticleCardiovascular research2020
Moderate but not severe hypothermia causes pro-arrhythmic changes in cardiac electrophysiology.
Article in Cardiovascular research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Prediction of Ventricular Arrhythmias by QRS/QTc - Ratio in Citalopram or Escitalopram Intoxication.Frontiers in medicine · 2022Pooled it
- Seawater Immersion Hypothermia Triggers Cardiac Pyroptosis via the NF-κB/NLRP3 Inflammasome Axis: A Mechanistic Study in Rats.International journal of molecular sciences · 2026Article
- Systemic hypothermia in non-aortic cardiac surgery: a narrative review.Journal of thoracic disease · 2026Review
- Can hypothermia-induced changes in QRS and QT(c) intervals predict cardiac arrest?BMC research notes · 2026Article
- Machine learning-driven prediction of in-hospital cardiac arrest among critically ill patients with traumatic spinal cord injury: a multicenter cohort study.Frontiers in cardiovascular medicine · 2026Article
- Shenfu Decoction Extends Survival Time of Seawater-Induced Hypothermia in Rats: The Role of Metabolomics and Gut Microbiota.Current drug metabolism · 2026Article
- Seasonal variations in ventricular repolarization and tachyarrhythmias in hibernating brown bears (Ursus arctos arctos).Physiological reports · 2025Article
- Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial.Acta anaesthesiologica Scandinavica · 2025Article
- Cold-induced stress responses during a self-rescue exercise from accidental immersion in ice water in military personnel.Frontiers in physiology · 2025Article
- Post-surgical spontaneous paroxysmal hypothermia: a case series.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Article
- Hypothermia: Beyond the Narrative Review-The Point of View of Emergency Physicians and Medico-Legal Considerations.Journal of personalized medicine · 2023Review
- Proarrhythmic changes in human cardiomyocytes during hypothermia by milrinone and isoprenaline, but not levosimendan: an experimental in vitro study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Article
- Article
- Pharmacodynamic properties for inhibition of cAMP- and cGMP elimination by pentoxifylline remain unaltered in vitro during hypothermia.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Effect of Hypothermia on Myocardial Depolarization and Repolarization in Neonates with Hypoxic-Ischemic Encephalopathy Due to Asphyxia.Pediatric cardiology · 2022Article
- Review
- Conventional rigid 2D substrates cause complex contractile signals in monolayers of human induced pluripotent stem cell-derived cardiomyocytes.The Journal of physiology · 2022Article
- Early prediction of hypothermia in pediatric intensive care units using machine learning.Frontiers in physiology · 2022Article
- Comparison of Perioperative Active or Routine Temperature Management on Postoperative Quality of Recovery in PACU in Patients Undergoing Thoracoscopic Lobectomy: A Randomized Controlled Study.International journal of general medicine · 2022Article
- [The end of an era? Target temperature management after out-of-hospital cardiac arrest].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2021Article
Corrections and comments
- Erratum issuedCorrigendum.2020
Authors and funding
10 authors at 3 institutions in 2 countries.
Funding
Abstract
aimsTreatment of arrhythmias evoked by hypothermia/rewarming remains challenging, and the underlying mechanisms are unclear. This in vitro experimental study assessed cardiac electrophysiology in isolated rabbit hearts at temperatures occurring in therapeutic and accidental hypothermia. METHODS AND
resultsDetailed ECG, surface electrogram, and panoramic optical mapping were performed in isolated rabbit hearts cooled to moderate (31°C) and severe (17°C) hypothermia. Ventricular activation was unchanged at 31°C while action potential duration (APD) was significantly prolonged (176.9 ± 4.2 ms vs. 241.0 ± 2.9 ms, P < 0.05), as was ventricular repolarization. At 17°C, there were proportionally similar delays in both activation and repolarization. These changes were reflected in the QRS and QT intervals of ECG recordings. Ventricular fibrillation threshold was significantly reduced at 31°C (16.3 ± 3.1 vs. 35 ± 3.5 mA, P < 0.05) but increased at 17°C (64.2 ± 9.9, P < 0.05). At 31°C, transverse conduction was relatively unchanged by cooling compared to longitudinal conduction, but at 17°C both transverse and longitudinal conduction were proportionately reduced to a similar extent. The gap junction uncoupler heptanol had a larger relative effect on transverse than longitudinal conduction and was able to restore the transverse/longitudinal conduction ratio, returning ventricular fibrillation threshold to baseline values (16.3 ± 3.1 vs. 36.3 ± 4.3 mA, P < 0.05) at 31°C. Rewarming to 37°C restored the majority of the electrophysiological parameters.
conclusionsModerate hypothermia does not significantly change ventricular conduction time but prolongs repolarization and is pro-arrhythmic. Further cooling to severe hypothermia causes parallel changes in ventricular activation and repolarization, changes which are anti-arrhythmic. Therefore, relative changes in QRS and QT intervals (QR/QTc) emerge as an ECG-biomarker of pro-arrhythmic activity. Risk for ventricular fibrillation appears to be linked to the relatively low temperature sensitivity of ventricular transmural conduction, a conclusion supported by the anti-arrhythmic effect of heptanol at 31°C.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.