title: A method to remove CPR artefacts from human ECG using only the recorded ECG.
abstract: OBJECTIVE
  To show the possibility of using cardiopulmonary resuscitation (CPR) artefact suppression methods that do not need additional reference signals to model CPR artefacts.
  
  
  METHODS
  A CPR suppression method based on a Kalman filter was designed. The artefact was modelled using the fundamental frequency of the compressions, estimated from the spectral analysis of the ECG. Artificial mixtures of human shockable rhythms and CPR artefacts were used to design the algorithm that was then tested on samples obtained from real out-of-hospital cardiac arrest episodes.
  
  
  RESULTS
  The shock/no-shock decision of an automated external defibrillator (AED) was evaluated before and after CPR suppression for 131 shockable and 347 non-shockable samples. The sensitivity improved from 56% (95% CI, 47-64%) to 90% (95% CI, 84-94%). However, the specificity decreased from 91% (95% CI, 87-93%) to 80% (95% CI, 76-84%).
  
  
  CONCLUSIONS
  CPR artefacts can be suppressed using methods based on the analysis of the ECG alone. The hardware of current AEDs does not need to be replaced, although better artefact suppression methods exist for modified AEDs with additional reference channels.
authors: Department of Electronics and Telecommunications, University of the Basque Country, Alameda de Urquijo s/n, 48013-Bilbao, Spain. sofia.ruizdegauna@ehu.es
authors: Sofia
authors: S
authors: Ruiz de Gauna
authors: Jesus
authors: J
authors: Ruiz
authors: Unai
authors: U
authors: Irusta
authors: Elisabete
authors: E
authors: Aramendi
authors: Trygve
authors: T
authors: Eftestøl
authors: Jo
authors: J
authors: Kramer-Johansen
mesh_terms: D000465:Algorithms; D016477:Artifacts; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D004554:Electric Countershock / Q000295:instrumentation; D004562:Electrocardiography / Q000379:methods*; D004632:Emergency Medical Services; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity