ECG Changes during Septic Shock

We have previously found that skeletal muscle becomes electrically inexcitable in septic patients. Work in an animal model suggests that a decrease in the available sodium current underlies the loss of electrical excitability. We examined ECGs from patients during periods of septic shock to determin...

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Bibliographic Details
Published inCardiology Vol. 97; no. 4; pp. 187 - 196
Main Authors Rich, Mark M., McGarvey, Mike L., Teener, James W., Frame, Lawrence H.
Format Journal Article
LanguageEnglish
Published Basel, Switzerland Karger 01.01.2002
S. Karger AG
Subjects
Adult
Aged
Autopsy
Biological and medical sciences
Cardiac dysrhythmias
Cardiology. Vascular system
Electrocardiography
Female
General Cardiology
Heart
Heart Conduction System - physiopathology
Humans
Intensive Care Units
Male
Medical sciences
Middle Aged
Philadelphia
Retrospective Studies
Severity of Illness Index
Shock, Septic - etiology
Shock, Septic - physiopathology
Philadelphia
Cardiac excitability
Low QRS voltage
Sepsis
Systemic inflammatory response syndrome
Shock
Human
Arrhythmia
Septicemia
QRS interval
Clinical form
Cardiovascular disease
Bundle branch block
Conduction disorder
Electrodiagnosis
Heart block
Heart disease
Electrocardiography
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Summary:We have previously found that skeletal muscle becomes electrically inexcitable in septic patients. Work in an animal model suggests that a decrease in the available sodium current underlies the loss of electrical excitability. We examined ECGs from patients during periods of septic shock to determine whether there were any ECG abnormalities that might suggest a similar loss of excitability in cardiac tissue during sepsis. Fourteen out of 17 patients had low or significantly decreased QRS amplitudes during septic shock; 8 of 17 had long or increased QRS duration with or without bundle branch block. The mean decrease in QRS amplitude in septic patients was 41%, significantly higher than in controls where no consistent decrease in QRS amplitude was found (p < 0.01). In patients who recovered from septic shock, the QRS amplitude and the increased QRS duration both returned to normal. We conclude that there is a loss of QRS amplitude during septic shock that may be due to altered cardiac excitability.
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ISSN:0008-6312
1421-9751
DOI:10.1159/000063120