title: Removal of cardiopulmonary resuscitation artifacts with an enhanced adaptive filtering method: an experimental trial.
abstract: Current automated external defibrillators mandate interruptions of chest compression to avoid the effect of artifacts produced by CPR for reliable rhythm analyses. But even seconds of interruption of chest compression during CPR adversely affects the rate of restoration of spontaneous circulation and survival. Numerous digital signal processing techniques have been developed to remove the artifacts or interpret the corrupted ECG with promising result, but the performance is still inadequate, especially for nonshockable rhythms. In the present study, we suppressed the CPR artifacts with an enhanced adaptive filtering method. The performance of the method was evaluated by comparing the sensitivity and specificity for shockable rhythm detection before and after filtering the CPR corrupted ECG signals. The dataset comprised 283 segments of shockable and 280 segments of nonshockable ECG signals during CPR recorded from 22 adult pigs that experienced prolonged cardiac arrest. For the unfiltered signals, the sensitivity and specificity were 99.3% and 46.8%, respectively. After filtering, a sensitivity of 93.3% and a specificity of 96.0% were achieved. This animal trial demonstrated that the enhanced adaptive filtering method could significantly improve the detection of nonshockable rhythms without compromising the ability to detect a shockable rhythm during uninterrupted CPR.
authors.affiliation: School of Biomedical Engineering, Third Military Medical University and Chongqing University, 30 Gaotanyan Main Street, Chongqing 400038, China.
authors.forename: Yushun
authors.initials: Y
authors.lastname: Gong
authors.affiliation: Emergency Department, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou 510120, China ; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-Sen University, Guangzhou 510120, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Yu
authors.affiliation: School of Biomedical Engineering, Third Military Medical University and Chongqing University, 30 Gaotanyan Main Street, Chongqing 400038, China.
authors.forename: Bihua
authors.initials: B
authors.lastname: Chen
authors.affiliation: School of Biomedical Engineering, Third Military Medical University and Chongqing University, 30 Gaotanyan Main Street, Chongqing 400038, China.
authors.forename: Mi
authors.initials: M
authors.lastname: He
authors.affiliation: School of Biomedical Engineering, Third Military Medical University and Chongqing University, 30 Gaotanyan Main Street, Chongqing 400038, China ; Institute of Cardiopulmonary Cerebral Resuscitation, Sun Yat-Sen University, Guangzhou 510120, China.
authors.forename: Yongqin
authors.initials: Y
authors.lastname: Li
mesh_terms: D000465:Algorithms; D000818:Animals; D016477:Artifacts; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006323:Heart Arrest / Q000175:diagnosis* / Q000517:prevention & control*; D008297:Male; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013552:Swine; D016896:Treatment Outcome