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Fully automatic rhythm analysis during chest compression pauses
1Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
Resuscitation
|January 27, 2015
Summary
An automatic method reliably analyzes heart rhythms during ventilation pauses in cardiopulmonary resuscitation (CPR). This improves shock delivery and increases chest compression fraction in cardiac arrest patients.
Area of Science:
- Emergency Medicine
- Cardiology
- Biomedical Engineering
Background:
- Chest compressions during cardiopulmonary resuscitation (CPR) create artefacts that hinder accurate rhythm analysis.
- Ventilation pauses in 30:2 CPR offer a window for rhythm assessment without compression artefacts.
Purpose of the Study:
- To validate a fully automatic method for reliable and accurate rhythm analysis during ventilation pauses in 30:2 CPR.
- To assess the feasibility of advancing defibrillation shocks and improving chest compression fraction (CCF).
Main Methods:
- Analysis of 1414 minutes of 30:2 CPR data from 135 out-of-hospital cardiac arrest cases.
- Utilized an automatic pause detector based on transthoracic impedance to identify pauses >3.5s.
- Employed a shock advice algorithm (SAA) to analyze 3-second ECG segments during pauses for rhythm diagnosis.
Main Results:
- The automatic pause detector demonstrated 93.5% sensitivity and 97.3% positive predictive value (PPV).
- The SAA achieved 93.8% sensitivity and 95.9% specificity in rhythm analysis during detected pauses.
- The method could have advanced shocks in 97% of cases and avoided rhythm reassessment pauses in 95.2% of nonshockable rhythms, increasing CCF.
Conclusions:
- A fully automatic rhythm analysis method during ventilation pauses is safe and accurate.
- This approach facilitates early detection of refibrillation and enhances CCF in patients with nonshockable rhythms.
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