An Algorithm Used for Ventricular Fibrillation Detection Without Interrupting Chest Compression

被引:47
作者
Li, Yongqin [1 ,3 ]
Bisera, Joe [1 ]
Weil, Max Harry [1 ,2 ]
Tang, Wanchun [1 ,2 ]
机构
[1] Weil Inst Crit Care Med, Rancho Mirage, CA 92270 USA
[2] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA
[3] Third Mil Med Univ, Sch Biomed Engn & Med Imaging, Chongqing 400038, Peoples R China
关键词
Cardiac arrest; cardiopulmonary resuscitation (CPR); chest compression; morphology consistency evaluation; ventricular fibrillation (VF) detection; CARDIOPULMONARY-RESUSCITATION; CPR ARTIFACTS; DEFIBRILLATION; REMOVAL; ARRHYTHMIAS; TACHYCARDIA; COMPLEXITY; DEATH;
D O I
10.1109/TBME.2011.2118755
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Ventricular fibrillation (VF) is the primary arrhythmic event in the majority of patients suffering from sudden cardiac arrest. Attention has been focused on this particular rhythm since it is recognized that prompt therapy, especially electrical defibrillation, may lead to a successful outcome. However, current versions of automated external defibrillators (AEDs) mandate repetitive interruptions of chest compression for rhythm analyses since artifacts produced by chest compression during cardiopulmonary resuscitation (CPR) preclude reliable electrocardiographic (ECG) rhythm analysis. Yet, repetitive interruptions in chest compression are detrimental to the success of defibrillation. The capability for rhythm analysis without requiring "hands-off" intervals will allow for more effective resuscitation. In this paper, a novel continuous-wavelet-transformation-based morphology consistency evaluation algorithm was developed for the detection of disorganized VF from organized sinus rhythm (SR) without interrupting the ongoing chest compression. The performance of this method was evaluated on both uncorrupted and corrupted ECG signals recorded from AEDs obtained from out-of-hospital victims of cardiac arrest. A total of 232 patients and 31 092 episodes of either VF or SR were accessed, in which 8195 episodes were corrupted by artifacts produced by chest compressions. We also compared the performance of this method with three other established algorithms, including VF filter, spectrum analysis, and complexity measurement. Even though there was a modest decrease in specificity and accuracy when chest compression artifact was present, the performance of this method was still superior to other reported methods for VF detection during uninterrupted CPR.
引用
收藏
页码:78 / 86
页数:9
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