Change in 12-lead ECG classification from OH to ED setting in patients resuscitated from out-of-hospital cardiac arrest (OHCA) was common (49%). The OH STEMI classification changed to a less ischemic (non-STEMI) ED classification in 67% of cases.

From 7/27/12 to 7/18/19, 176 patients were entered with a mean age of 61.2 ± 16.6 years; 102/176 (58%) were male.

Overall, 504 OH and ED 12-lead ECGs were acquired (2.9 ECGs/patient).

Electrocardiogram (ECG) classification inter-rater reliability kappa score was 0.63 ± 0.02 (substantial agreement).

Overall, 86/176 (49%) changed ECG classification from the OH to ED setting; 69/86 (80%) of these ECGs changed from more to less ischemic classifications.

Of 49 OH STEMI ECG classifications, 33/49 (67%) changed to a less ischemic (non-STEMI) ED ECG classification.

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