Aims: We investigated whether the Heart Rate Variability (HRV) could predict the 24 hours and 30 days outcome after out-of-hospital cardiac arrest (OHCA). And whether there is a possible correlation between the 24 hours evolution of HRV between two ECG’s and the outcome. Also a possible correlation between C-reactive protein (CRP) and HRV was investigated. Finally, we evaluated a new variable, the vagal neuroimmunomodulation (NIM) index (HRV divided by CRP) as a potential prognostic variable.
Materials and methods: This retrospective study included 133 patients who were admitted to two emergency departments (ED) (an university and a general hospital). The first ECG was recorded upon admission at the ED. The Standard Deviation of the Normal-to-Normal intervals (SDNN) and the Root Mean Square of the Successive Differences (RMSSD) were calculated manually of a 5 second recording on the first ECG and on the ECG 24h later.
Results: 133 patients between 23 and 89 years met the inclusion criteria. SDNN and RMSSD were compared between the survivors and non-survivors after 24 hours (n=113 (85%) versus n=20 (15%)) and after 30 days (n=40 (31%) versus n=93 (69%)). In the group older than 67, the logarithmic SDNN (p=0.045) and logarithmic RMSSD (p= 0.027) were significantly correlated with the outcome after 30 days. There was a significant result for the logarithmic SDNN difference (p=0.029), the logarithmic RMSSD differences (p= 0.046) and the RMSSD differences (p= 0.044) with the mortality after 30 days in the group older than 67. A low positive correlation between RMSSD and the CRP (p<0.001; r= 0.316) was found, especially in the survivor group. A significant result between the NIM (logarithmic SDNN/CRP) and the mortality after 24 hours was found (p= 0.046) in the group older than 67.
Conclusion: NIM defined as logarithmic SDNN/CRP correlates well with the 24 hours mortality in the group older than 67.  The logarithmic SDNN and RMSSD was a good predictor of the 30 days-mortality in patients older than 67. Finally, a positive logarithmic difference of SDNN or RMSSD also predict the 30 days-mortality in the group older than 67.

_Aims_: We investigated whether the Heart Rate Variability (HRV) could predict the 24 hours and 30 days outcome after out-of-hospital cardiac arrest (OHCA). And whether there is a possible correlation between the 24 hours evolution of HRV between two ECG’s and the outcome. Also a possible correlation between C-reactive protein (CRP) and HRV was investigated. Finally, we evaluated a new variable, the vagal neuroimmunomodulation (NIM) index (HRV divided by CRP) as a potential prognostic variable.
_Materials and methods_: This retrospective study included 133 patients who were admitted to two emergency departments (ED) (an university and a general hospital). The first ECG was recorded upon admission at the ED. The Standard Deviation of the Normal-to-Normal intervals (SDNN) and the Root Mean Square of the Successive Differences (RMSSD) were calculated manually of a 5 second recording on the first ECG and on the ECG 24h later.
_Results_: 133 patients between 23 and 89 years met the inclusion criteria. SDNN and RMSSD were compared between the survivors and non-survivors after 24 hours (n=113 (85%) versus n=20 (15%)) and after 30 days (n=40 (31%) versus n=93 (69%)). In the group older than 67, the logarithmic SDNN (p=0.045) and logarithmic RMSSD (p= 0.027) were significantly correlated with the outcome after 30 days. There was a significant result for the logarithmic SDNN difference (p=0.029), the logarithmic RMSSD differences (p= 0.046) and the RMSSD differences (p= 0.044) with the mortality after 30 days in the group older than 67. A low positive correlation between RMSSD and the CRP (p<0.001; r= 0.316) was found, especially in the survivor group. A significant result between the NIM (logarithmic SDNN/CRP) and the mortality after 24 hours was found (p= 0.046) in the group older than 67.
_Conclusion_: NIM defined as logarithmic SDNN/CRP correlates well with the 24 hours mortality in the group older than 67.  The logarithmic SDNN and RMSSD was a good predictor of the 30 days-mortality in patients older than 67. Finally, a positive logarithmic difference of SDNN or RMSSD also predict the 30 days-mortality in the group older than 67.

The Prognostic Value of Heart Rate Variability after Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest Patients.

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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