Dickey W, Dalzell G W, Anderson J M, Adgey A A
Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast, N. Ireland.
Eur Heart J. 1992 May;13(5):608-15. doi: 10.1093/oxfordjournals.eurheartj.a060223.
The accuracy of decision-making of a semi-automatic defibrillator was assessed at 57 cardiac arrests in 55 patients. The initial rhythm was ventricular fibrillation at 40 arrests and was correctly identified in 37 (sensitivity 92.5%). In the other 17 arrests initial rhythms were not ventricular fibrillation and 16 were correctly identified (specificity 94%). Continuous electrocardiographic recordings of the arrests were analysed in 8-12 s segments: of 432 segments showing ventricular fibrillation, 352 were correctly identified (sensitivity 81%); 3895 of 4139 segments showing rhythms other than ventricular fibrillation were correctly identified (specificity 94%). The percentage accuracy of detection of ventricular fibrillation varied from 0-100% (mean 91%) and for non-ventricular fibrillation from 51-100% (mean 92%). When 104 segments of ventricular fibrillation and 470 segments of non-ventricular fibrillation with cardiopulmonary resuscitation artefact were excluded from the analysis, a sensitivity of 91% and specificity of 96% were obtained. Thus the detection of cardiac arrest rhythms using a microprocessor based detection system for patients with cardiac arrest has a high sensitivity for ventricular fibrillation and specificity for non-ventricular fibrillation.
对55例患者发生的57次心脏骤停事件，评估了半自动除颤器的决策准确性。40次心脏骤停的初始心律为心室颤动，其中37次被正确识别（敏感性92.5%）。在另外17次心脏骤停事件中，初始心律不是心室颤动，其中16次被正确识别（特异性94%）。对心脏骤停事件的连续心电图记录按8 - 12秒的片段进行分析：在显示心室颤动的432个片段中，352个被正确识别（敏感性81%）；在显示非心室颤动心律的4139个片段中，3895个被正确识别（特异性94%）。心室颤动检测的准确率在0 - 100%之间（平均91%），非心室颤动检测的准确率在51 - 100%之间（平均92%）。当从分析中排除104个伴有心肺复苏伪差的心室颤动片段和470个非心室颤动片段后，获得了91%的敏感性和96%的特异性。因此，使用基于微处理器的检测系统对心脏骤停患者的心脏骤停心律进行检测，对心室颤动具有高敏感性且对非心室颤动具有高特异性。
