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Cardiac arrest
ECG signs appear minutes before post-ROSC rearrest
Early Identification of Recurrent Out-of-hospital Cardiac Arrest Using Clinical ECG Features
Resuscitation · 2026-10 · Added 31 October 2026
A US retrospective cohort of 1,298 post-ROSC OHCA patients found routine ECG features — wider QRS, lower heart rate, higher heart-rate variability — were associated with rearrest, with prediction best one minute before it (AUROC 0.74).
- Study type
- Cohort
- Design
- Retrospective cohort, 2018–2024
- Participants
- 1,298 adults with OHCA achieving ROSC
- Main finding
- 40.7% of post-ROSC patients rearrested; identification was highest one minute before rearrest (AUROC 0.74) and declined beyond three minutes; rearrest carried lower survival (20.4% vs 43.1%) and favourable neuro outcome (7.8% vs 21.2%)
- Caveat
- Retrospective, single US region, and no prospective test of acting on the prediction
- Bottom line
- Hypothesis-generating
Why it matters in Australia (High relevance). Continuous ECG monitoring after ROSC is standard care on every Australian ambulance; the question it raises — watching for rearrest rather than waiting for it — is one crews can act on.
Learning goal
Recognise ECG warning signs that precede rearrest in post-ROSC patients to intervene earlier.
More
- Topic: Cardiac arrest
- Daily scan: 31 October 2026
- Podcast: Paramedic Papers Daily, 31 October 2026
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