Inappropriate analyses of automated external defibrillators used during in-hospital ventricular fibrillation.
The use of automated external defibrillators (AEDs) has increased the number of survivors of out-of-hospital cardiac arrest. The AED has a high specificity and moderately high sensitivity in detecting rhythms appropriately treated by defibrillation. However, a few shockable rhythms are misdiagnosed by the AED. Two cases of inappropriate analyses by AEDs in patients with in-hospital ventricular fibrillation are presented. In the first case, the AED failed to recognize ventricular fibrillation because of the presence of pacemaker spikes. In the second case, the fine ventricular fibrillation and the presence of artifacts were suspected as the causes of inappropriate analysis by the AED. Both patients were resuscitated by advanced cardiovascular life support with a manual defibrillator. Trained healthcare providers should be aware of the limitations of AED in specific situations.
Yamamoto
Takeshi
T
Intensive and Cardiac Care Unit, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. yamamoto56@nms.ac.jp
Takayama
Morimasa
M
Sato
Naoki
N
Yodogawa
Kenji
K
Iwasaki
Yu-Ki
YK
Kato
Koji
K
Yoshida
Asuka
A
Yoshida
Ryusuke
R
Tanaka
Keiji
K
Takano
Teruo
T
Mizuno
Kyoichi
K
D000368:Aged; D000369:Aged, 80 and over; D047548:Defibrillators / Q000009:adverse effects* / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D010138:Pacemaker, Artificial; D006435:Renal Dialysis / Q000009:adverse effects; D012680:Sensitivity and Specificity; D014693:Ventricular Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*