A Reliable Method for Rhythm Analysis during Cardiopulmonary Resuscitation

Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is stil...

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Bibliographic Details
Published in:BioMed research international 2014-01, Vol.2014 (2014), p.1-11
Main Authors: Ayala, U., Irusta, Unai, Ruiz, Jesus, Eftestøl, Trygve, Kramer-Johansen, J., Alonso-Atienza, F., Alonso, E., González-Otero, D.
Format: Article
Language:English
Subjects:
Algorithms
Biological rhythms
Cardiopulmonary Resuscitation
CPR
CPR (First aid)
Databases as Topic
Defibrillators
Electrophysiological Phenomena
Electroshock
Heart attacks
Heart Rate - physiology
Humans
Measurement
Methods
Out-of-Hospital Cardiac Arrest - physiopathology
Studies
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Summary:Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies.
ISSN:2314-6133
2314-6141
DOI:10.1155/2014/872470