title: A reliable method for rhythm analysis during cardiopulmonary resuscitation.
abstract: Interruptions in cardiopulmonary resuscitation (CPR) compromise defibrillation success. However, CPR must be interrupted to analyze the rhythm because although current methods for rhythm analysis during CPR have high sensitivity for shockable rhythms, the specificity for nonshockable rhythms is still too low. This paper introduces a new approach to rhythm analysis during CPR that combines two strategies: a state-of-the-art CPR artifact suppression filter and a shock advice algorithm (SAA) designed to optimally classify the filtered signal. Emphasis is on designing an algorithm with high specificity. The SAA includes a detector for low electrical activity rhythms to increase the specificity, and a shock/no-shock decision algorithm based on a support vector machine classifier using slope and frequency features. For this study, 1185 shockable and 6482 nonshockable 9-s segments corrupted by CPR artifacts were obtained from 247 patients suffering out-of-hospital cardiac arrest. The segments were split into a training and a test set. For the test set, the sensitivity and specificity for rhythm analysis during CPR were 91.0% and 96.6%, respectively. This new approach shows an important increase in specificity without compromising the sensitivity when compared to previous studies.
authors.affiliation: Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
authors.forename: U
authors.initials: U
authors.lastname: Ayala
authors.affiliation: Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
authors.forename: U
authors.initials: U
authors.lastname: Irusta
authors.affiliation: Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
authors.affiliation: Department of Electrical Engineering and Computer Science, Faculty of Science and Technology, University of Stavanger, 4036 Stavanger, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Eftestøl
authors.affiliation: Norwegian Centre for Prehospital Emergency Care (NAKOS), Oslo University Hospital and University of Oslo, 0424 Oslo, Norway.
authors.forename: J
authors.initials: J
authors.lastname: Kramer-Johansen
authors.affiliation: Department of Signal Theory and Communications, University Rey Juan Carlos, Camino del Molino S/N, 28943 Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Alonso-Atienza
authors.affiliation: Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Alonso
authors.affiliation: Communications Engineering Department, University of the Basque Country UPV/EHU, Alameda Urquijo S/N, 48013 Bilbao, Spain.
authors.forename: D
authors.initials: D
authors.lastname: González-Otero
mesh_terms: D000465:Algorithms; D016887:Cardiopulmonary Resuscitation; D019992:Databases as Topic; D055724:Electrophysiological Phenomena; D004597:Electroshock; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D058687:Out-of-Hospital Cardiac Arrest / Q000503:physiopathology