Sinus bradycardia develops and can be followed by AF. Below 32°C, ventricular arrhythmias including ventricular fibrillation (VF) may occur. Finally, asystole [6] results. Note Osborn waves are another EGC abnormality
Note that malignant arrhythmias are unlikely to be hypothermia-induced at temperatures above 32°C – consider alternative causes such as acute coronary syndrome (ACS).
The rhythm strips below show the different stages of hypothermia.