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Archivos de cardiología de México
On-line version ISSN 1665-1731Print version ISSN 1405-9940
Abstract
PALACIOS-RUBIOA, Julián et al. Early prognostic value of an Algorithm based on spectral Variables of Ventricular fibrillAtion from the EKG of patients with suddEn cardiac death: A multicentre observational study (AWAKE). Arch. Cardiol. Méx. [online]. 2018, vol.88, n.5, pp.460-467. Epub Dec 04, 2020. ISSN 1665-1731. https://doi.org/10.1016/j.acmx.2018.05.003.
Objective:
Ventricular fibrillation (VF)-related sudden cardiac death (SCD) is a leading cause of mortality and morbidity. Current biological and imaging parameters show significant limitations on predicting cerebral performance at hospital admission. The AWAKE study (NCT03248557) is a multicentre observational study to validate a model based on spectral ECG analysis to early predict cerebral performance and survival in resuscitated comatose survivors.
Methods:
Data from VF ECG tracings of patients resuscitated from SCD will be collected using an electronic Case Report Form. Patients can be either comatose (Glasgow Coma Scale GCS --- ≤8) survivors undergoing temperature control after return of spontaneous circulation (RoSC), or those who regain consciousness (GCS = 15) after RoSC; all admitted to Intensive Cardiac Care Units in 4 major university hospitals. VF tracings prior to the first direct current shock will be digitized and analyzed to derive spectral data and feed a predictive model to estimate favorable neurological performance (FNP). The results of the model will be compared to the actual prognosis.
Results:
The primary clinical outcome is FNP during hospitalization. Patients will be categorized into 4 subsets of neurological prognosis according to the risk score obtained from the predictive model. The secondary clinical outcomes are survival to hospital discharge, and FNP and survival after 6 months of follow-up. The model-derived categorisation will be also compared with clinical variables to assess model sensitivity, specificity, and accuracy.
Conclusions:
A model based on spectral analysis of VF tracings is a promising tool to obtain early prognostic data after SCD.
Keywords : Coma; Sudden cardiac death; Ventricular fibrillation; Wavelet analysis; Prognosis; Resuscitation; Spain.