title: Comparison of electrocardiographic characteristics of adults and children for automated external defibrillator algorithms.
abstract: Accurate rhythm identification is vital for appropriate shock delivery during pediatric resuscitation with an automated external defibrillator. Currently, extensive testing of pediatric algorithms is recommended. The aims of our study were to determine age-related differences in electrocardiographic (ECG) tracings in children and adults and to determine if differences warrant evaluating each algorithm against pediatric rhythms. We hypothesized that the ECG characteristics of heart rate, amplitude, and conduction velocity differ between children younger than 8 years and adults. We evaluated 442 separate ECG tracings from 199 pediatric patients and 839 samples from 170 adults to measure differences in the 3 variables. Rhythms chosen were normal sinus rhythm (NSR), supraventricular tachycardia (SVT), and ventricular tachycardia (VT). Significant differences were found between heart rates of children and adults with NSR and SVT but not VT. There were significant differences between adult and pediatric signal amplitudes in both NSR and SVT but no difference in signal amplitude of VT. When NSR between adults and children was compared, adults proved to have a faster conduction velocity. There was no difference in conduction velocity of SVT or VT between children and adults. We conclude that common rhythms in pediatric patients have differing characteristics, which may affect the accuracy of an automated external defibrillator algorithm, and that specific testing with tracings obtained from children is warranted.
authors.affiliation: From the Departments of *Anesthesia and †Pediatrics, University of Iowa Children's Hospital, University of Iowa Carver College of Medicine, Iowa City, IA.
authors.forename: Brant A
authors.initials: BA
authors.lastname: Rustwick
authors.forename: Dianne L
authors.initials: DL
authors.lastname: Atkins
mesh_terms: D000328:Adult; D000367:Age Factors; D000465:Algorithms; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D047548:Defibrillators; D004554:Electric Countershock / Q000295:instrumentation*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn