Is arrhythmia detection by automatic external defibrillator accurate for children?: sensitivity and specificity of an automatic external defibrillator algorithm in 696 pediatric arrhythmias.
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.
Cecchin
F
F
University of Washington, Seattle, USA. fcecch@chmc.org
Jorgenson
D B
DB
Berul
C I
CI
Perry
J C
JC
Zimmerman
A A
AA
Duncan
B W
BW
Lupinetti
F M
FM
Snyder
D
D
Lyster
T D
TD
Rosenthal
G L
GL
Cross
B
B
Atkins
D L
DL
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