The R-R interval variation as the good outcomes predictor in survivors after cardiac arrest with targeted temperature management

Heart rate and heart rate variability as a prognosticating feature for functional outcome after cardiac arrest: A scoping review

“…Of the 621 articles identified in our search, 12 qualified for full-text review following title and abstract screening, of which five were included in the analysis. 9 , 12 , 13 , 16 , 17 Out of 7 studies excluded after full-text-review, two studies were about predicting heart failure, three studies did not observe functional outcome, and two studies did not analyze ECG-related parameters. Two papers were further added after checking reference lists for the identification of additional, relevant studies.…”

“…Length of HR segments not specified CPC and modified Rankin scale at 180 days Yes 239 208 All TTM, target temp: 33C The group with lowest HR had lowest odds of unfavorable functional outcome Huang et al 2017 11 1 HR (and MAP and CI) for 48 hours (measurement starts 3 hours within ICU admission) CPC at hospital discharge Yes for Epinephrine 21 75 All TTM, target temp: 33C. Only study to include data post TTM Lower HR at 48 hours was significantly associated with better functional outcome at discharge Muengtaweepongsa et al 2017 12 1 RR interval variation (maximum RR – minimum RR) during TTM starting when the target temperature of 33C was achieved for a duration of about 24 hours CPC at hospital discharge No 12 34 All TTM, target temp: 33C Patients with favorable functional outcomes had significantly higher RRIV rates Oksanen et al 2018 13 20 Time-weighted HR during 48–72 hours in ICU GOS at one year Yes 202 302 TTM (target temp: 33C) and no TTM Patients with favorable functional outcome had lower time-weighted HR during the first 48 hours Endoh et al 2019 14 1 HRV related features during 8 hours within 24 hours post-ROSC GOS 14 days after ROSC No 22 54 All TTM, target temp: 34C VLF power, detrended fluctuation, and MSE were significantly higher in the group with favorable outcome Riganello et al 2022 15 4 HRV MSE for 15 minutes during TTM. In first 24 hours after cardiac arrest for no-TTM patients Best CPC within 3 months No 43 36 Three groups: TTM (target temp: 33, 36), no TTM Long and short term MSE were significantly different between functional outcome groups *4 medications used: Epinephrine, norepinephrine, dopamine, dobutamine; HR = heart rate; ROSC = return of spontaneous circulation; CPC = cerebral performance category; TTM = targeted temperature management; MAP = mean arterial pressure; CI = cardiac index; ICU = intensiv...…”

“…All studies were retrospective in nature, with 3 multicenter 10 , 13 , 17 and 4 single-center in study design. 9 , 11 , 12 , 16 HR was explored in four 10 , 11 studies, HRV in two, 16 , 17 and RR interval variation in one. 12 Three studies measured outcome at hospital discharge, 9 , 11 , 12 one 14 days after return of spontaneous circulation (ROSC), 16 two after 3 months, 10 , 17 and one after 1 year.…”

“… 9 , 11 , 12 , 16 HR was explored in four 10 , 11 studies, HRV in two, 16 , 17 and RR interval variation in one. 12 Three studies measured outcome at hospital discharge, 9 , 11 , 12 one 14 days after return of spontaneous circulation (ROSC), 16 two after 3 months, 10 , 17 and one after 1 year. 13 CPC was used as the outcome measure in five 10 , 11 , 12 studies, Glasgow outcome score in two, 13 , 16 and modified Rankin scale in one.…”

“…It has been reported that temporal hemodynamics, including heart rate (HR) and HRV, may be associated with neurological outcomes after cardiac arrest. 9 , 10 , 11 , 12 , 13 , 14 , 15 A potential mechanism behind this association could be a connection between the heart’s autonomic responsiveness and the brain’s resilience or potential for recovery.…”