Electrocardiogram findings drastically change in the acute phase following out‐of‐hospital cardiac arrest (OHCA). “Transient conduction disturbance” was defined as a narrowing of QRS duration following OHCA. We showed that transient conduction disturbance is a significant predictor of 90‐day mortality among patients who experience OHCA. Aim A retrospective observational study to verify the impact of electrocardiograms (ECGs) following out‐of‐hospital cardiac arrest (OHCA) on mortality. Methods We retrospectively studied 101 OHCA patients who achieved a return of spontaneous circulation (ROSC) and survived for ≥3?h. Among them, 50 patients (66?±?17?years; 22 male) were evaluated using 12‐lead ECGs repeatedly and were included in the final analysis: immediately after ROSC (initial ECG) and after the initial evaluation in the emergency department (second ECG). Transient conduction disturbance (transient CD) was defined as a narrowing in QRS duration from the initial to second ECG of ≥18?ms. Multivariate Cox regression analyses were carried out to predict 90‐day mortality following OHCA. Results Among 50 OHCA patients, 30 patients survived for 90?days. Thirty patients had initial ventricular fibrillation rhythm. Median emergency medical services response time and low‐flow duration were 8 and 21?min, respectively. Multivariate analysis showed that the transient CD and low‐flow duration were significant predictors of all‐cause mortality (hazard ratio 16.55, 1.06;P ?=?0.001, 0.022, respectively). Conclusion Transient CD is a powerful predictor of 90‐day mortality in patients who survived 3?h after ROSC from OHCA.
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