title: Analyzing cardiac rhythm in the presence of chest compression artifact for automated shock advisory.
abstract: Defibrillation is often required to terminate a ventricular fibrillation or fast ventricular tachycardia rhythm and resume a perfusing rhythm in sudden cardiac arrest patients. Automated external defibrillators rely on automatic ECG analysis algorithms to detect the presence of shockable rhythms before advising the rescuer to deliver a shock. For a reliable rhythm analysis, chest compression must be interrupted to prevent corruption of the ECG waveform due to the artifact induced by the mechanical activity of compressions. However, these hands-off intervals adversely affect the success of treatment. To minimize the hands-off intervals and increase the chance of successful resuscitation, we developed a method which asks for interrupting the compressions only if the underlying ECG rhythm cannot be accurately determined during chest compressions. Using this method only a small percentage of cases need compressions interruption, hence a significant reduction in hands-off time is achieved. Our algorithm comprises a novel filtering technique for the ECG and thoracic impedance waveforms, and an innovative method to combine analysis from both filtered and unfiltered data. Requiring compression interruption for only 14% of cases, our algorithm achieved a sensitivity of 92% and specificity of 99%.
authors.affiliation: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA. Electronic address: saeed.babaeizadeh@philips.com.
authors.forename: Saeed
authors.initials: S
authors.lastname: Babaeizadeh
authors.affiliation: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA.
authors.forename: Reza
authors.initials: R
authors.lastname: Firoozabadi
authors.affiliation: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA.
authors.forename: Chengzong
authors.initials: C
authors.lastname: Han
authors.affiliation: Advanced Algorithm Research Center, Philips Healthcare, Andover, MA.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Helfenbein
mesh_terms: D000465:Algorithms; D016477:Artifacts; D056902:Clinical Alarms; D003131:Combined Modality Therapy / Q000379:methods; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D047548:Defibrillators; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D006336:Heart Massage / Q000379:methods*; D006801:Humans; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000517:prevention & control*
keywords: AED; Artifact removal; CPR; Cardiac rhythm; Chest compression; Defibrillation; ECG; Hands-off interval; Resuscitation; Shock advisory