title: Is arrhythmia detection by automatic external defibrillator accurate for children?: sensitivity and specificity of an automatic external defibrillator algorithm in 696 pediatric arrhythmias.
abstract: BACKGROUND
  Use of automatic external defibrillators (AEDs) in children aged <8 years is not recommended. The purpose of this study was to develop an ECG database of shockable and nonshockable rhythms from a broad age range of pediatric patients and to test the accuracy of the Agilent Heartstream FR2 Patient Analysis System for sensitivity and specificity.
  
  
  RESULTS
  Children aged </=12 years who either developed arrhythmias or were at risk for developing arrhythmias were studied. Two sources were used for the database: children whose rhythms were recorded prospectively via a modified AED and children who had arrhythmias captured on paper and digitized for subsequent analysis. The rhythms were divided into 5-second strips, classified by 3 reviewers, and then assessed by the AED analysis algorithm. A total of 696 five-second rhythm strips from 191 children (81 female and 110 male) aged 1 day to 12 years (median 3.0 years) were analyzed. There was 100% specificity for nonshockable rhythms. Sensitivity for ventricular fibrillation was 96%.
  
  
  CONCLUSIONS
  There was excellent AED rhythm analysis sensitivity and specificity in all age groups for ventricular fibrillation and nonshockable rhythms. The high specificity and sensitivity indicate that there is a very low risk of an inappropriate shock and that the AED correctly identifies shockable rhythms, making the algorithm both safe and effective for children.
authors.affiliation: University of Washington, Seattle, USA. fcecch@chmc.org
authors.forename: F
authors.initials: F
authors.lastname: Cecchin
authors.forename: D B
authors.initials: DB
authors.lastname: Jorgenson
authors.forename: C I
authors.initials: CI
authors.lastname: Berul
authors.forename: J C
authors.initials: JC
authors.lastname: Perry
authors.forename: A A
authors.initials: AA
authors.lastname: Zimmerman
authors.forename: B W
authors.initials: BW
authors.lastname: Duncan
authors.forename: F M
authors.initials: FM
authors.lastname: Lupinetti
authors.forename: D
authors.initials: D
authors.lastname: Snyder
authors.forename: T D
authors.initials: TD
authors.lastname: Lyster
authors.forename: G L
authors.initials: GL
authors.lastname: Rosenthal
authors.forename: B
authors.initials: B
authors.lastname: Cross
authors.forename: D L
authors.initials: DL
authors.lastname: Atkins
mesh_terms: D000328:Adult; D000465:Algorithms; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D019992:Databases as Topic; D004554:Electric Countershock / Q000295:instrumentation*; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D012042:Registries