Abstract
BACKGROUND: Pauses in chest compressions (CCs) have a negative association with survival from cardiac arrest. Electrocardiographic (ECG) rhythm analysis and defibrillator charging are significant contributors to CC pauses.
OBJECTIVE: Accuracy of the Analysis During Compressions with Fast Reconfirmation (ADC-FR) algorithm, which features automated rhythm analysis and charging during CCs to reduce CC pauses, was retrospectively determined in a large database of ECGs from 2701 patients with out-of-hospital cardiac arrest.
METHODS: The ADC-FR algorithm generated a total of 7264 advisories, of which 3575 were randomly assigned to a development data set and 3689 to a test data set. With ADC-FR, a high-pass digital filter is used to remove CC artifacts, while the underlying ECG rhythm is automatically interpreted. When CCs are paused at the end of the 2-minute cardiopulmonary resuscitation interval, a 3-second reconfirmation analysis is performed using the artifact-free ECG to confirm the shock/no-shock advisory. The sensitivity and specificity of the ADC-FR algorithm in correctly identifying shockable/nonshockable rhythms during CCs were calculated.
RESULTS: In both data sets, the accuracy of the ADC-FR algorithm for each ECG rhythm exceeded the recommended performance goals, which apply to a standard artifact-free ECG analysis. Sensitivity and specificity were 97% and 99%, respectively, for the development data set and 95% and 99% for the test data set.
CONCLUSION: The ADC-FR algorithm is highly accurate in discriminating shockable and nonshockable rhythms and can be used to reduce CC pauses.
| Original language | English |
|---|---|
| Pages (from-to) | 248-255 |
| Number of pages | 8 |
| Journal | Heart Rhythm |
| Volume | 15 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Feb 2018 |
Fingerprint
Keywords
- Algorithms
- Artifacts
- Cardiopulmonary Resuscitation/methods
- Electrocardiography
- Female
- Heart Massage
- Heart Rate/physiology
- Humans
- Male
- Out-of-Hospital Cardiac Arrest/physiopathology
- Retrospective Studies
- Time Factors
Cite this
Cardiac rhythm analysis during ongoing cardiopulmonary resuscitation using the Analysis During Compressions with Fast Reconfirmation technology. / Fumagalli, Francesca; Silver, Annemarie E; Tan, Qing; Zaidi, Naveed; Ristagno, Giuseppe.
In: Heart Rhythm, Vol. 15, No. 2, 02.2018, p. 248-255.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cardiac rhythm analysis during ongoing cardiopulmonary resuscitation using the Analysis During Compressions with Fast Reconfirmation technology
AU - Fumagalli, Francesca
AU - Silver, Annemarie E
AU - Tan, Qing
AU - Zaidi, Naveed
AU - Ristagno, Giuseppe
N1 - Copyright © 2017 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
PY - 2018/2
Y1 - 2018/2
N2 - BACKGROUND: Pauses in chest compressions (CCs) have a negative association with survival from cardiac arrest. Electrocardiographic (ECG) rhythm analysis and defibrillator charging are significant contributors to CC pauses.OBJECTIVE: Accuracy of the Analysis During Compressions with Fast Reconfirmation (ADC-FR) algorithm, which features automated rhythm analysis and charging during CCs to reduce CC pauses, was retrospectively determined in a large database of ECGs from 2701 patients with out-of-hospital cardiac arrest.METHODS: The ADC-FR algorithm generated a total of 7264 advisories, of which 3575 were randomly assigned to a development data set and 3689 to a test data set. With ADC-FR, a high-pass digital filter is used to remove CC artifacts, while the underlying ECG rhythm is automatically interpreted. When CCs are paused at the end of the 2-minute cardiopulmonary resuscitation interval, a 3-second reconfirmation analysis is performed using the artifact-free ECG to confirm the shock/no-shock advisory. The sensitivity and specificity of the ADC-FR algorithm in correctly identifying shockable/nonshockable rhythms during CCs were calculated.RESULTS: In both data sets, the accuracy of the ADC-FR algorithm for each ECG rhythm exceeded the recommended performance goals, which apply to a standard artifact-free ECG analysis. Sensitivity and specificity were 97% and 99%, respectively, for the development data set and 95% and 99% for the test data set.CONCLUSION: The ADC-FR algorithm is highly accurate in discriminating shockable and nonshockable rhythms and can be used to reduce CC pauses.
AB - BACKGROUND: Pauses in chest compressions (CCs) have a negative association with survival from cardiac arrest. Electrocardiographic (ECG) rhythm analysis and defibrillator charging are significant contributors to CC pauses.OBJECTIVE: Accuracy of the Analysis During Compressions with Fast Reconfirmation (ADC-FR) algorithm, which features automated rhythm analysis and charging during CCs to reduce CC pauses, was retrospectively determined in a large database of ECGs from 2701 patients with out-of-hospital cardiac arrest.METHODS: The ADC-FR algorithm generated a total of 7264 advisories, of which 3575 were randomly assigned to a development data set and 3689 to a test data set. With ADC-FR, a high-pass digital filter is used to remove CC artifacts, while the underlying ECG rhythm is automatically interpreted. When CCs are paused at the end of the 2-minute cardiopulmonary resuscitation interval, a 3-second reconfirmation analysis is performed using the artifact-free ECG to confirm the shock/no-shock advisory. The sensitivity and specificity of the ADC-FR algorithm in correctly identifying shockable/nonshockable rhythms during CCs were calculated.RESULTS: In both data sets, the accuracy of the ADC-FR algorithm for each ECG rhythm exceeded the recommended performance goals, which apply to a standard artifact-free ECG analysis. Sensitivity and specificity were 97% and 99%, respectively, for the development data set and 95% and 99% for the test data set.CONCLUSION: The ADC-FR algorithm is highly accurate in discriminating shockable and nonshockable rhythms and can be used to reduce CC pauses.
KW - Algorithms
KW - Artifacts
KW - Cardiopulmonary Resuscitation/methods
KW - Electrocardiography
KW - Female
KW - Heart Massage
KW - Heart Rate/physiology
KW - Humans
KW - Male
KW - Out-of-Hospital Cardiac Arrest/physiopathology
KW - Retrospective Studies
KW - Time Factors
U2 - 10.1016/j.hrthm.2017.09.003
DO - 10.1016/j.hrthm.2017.09.003
M3 - Article
C2 - 28917561
VL - 15
SP - 248
EP - 255
JO - Heart Rhythm
JF - Heart Rhythm
SN - 1547-5271
IS - 2
ER -