Aramendi Elisabete, de Gauna Sofia Ruiz, Irusta Unai, Ruiz Jesus, Arcocha M Fe, Ormaetxe Jose Miguel
Department of Electronics and Telecommunications, University of the Basque Country, Alameda de Urquijo s/n, 48013-Bilbao, Spain.
Resuscitation. 2007 Jan;72(1):115-23. doi: 10.1016/j.resuscitation.2006.05.017. Epub 2006 Nov 7.
Providing cardiopulmonary resuscitation (CPR) to a patient in cardiac arrest introduces artefacts into the electrocardiogram (ECG), corrupting the diagnosis of the underlying heart rhythm. CPR must therefore be discontinued for reliable shock advice analysis by an automated external defibrillator (AED). Detection of ventricular fibrillation (VF) during CPR would enable CPR to continue during AED rhythm analysis, thereby increasing the likelihood of resuscitation success. This study presents a new adaptive filtering method to clean the ECG. The approach consists of a filter that adapts its characteristics to the spectral content of the signal exclusively using the surface ECG that commercial AEDs capture through standard patches. A set of 200 VF and 25 CPR artefact samples collected from real out-of-hospital interventions were used to test the method. The performance of a shock advice algorithm was evaluated before and after artefact removal. CPR artefacts were added to the ECG signals and four degrees of corruption were tested. Mean sensitivities of 97.83%, 98.27%, 98.32% and 98.02% were achieved, producing sensitivity increases of 28.44%, 49.75%, 59.10% and 64.25%, respectively, sufficient for ECG analysis during CPR. Although satisfactory and encouraging sensitivity values have been obtained, further clinical and experimental investigation is required in order to integrate this type of artefact suppressing algorithm in current AEDs.
对心脏骤停患者进行心肺复苏（CPR）会在心电图（ECG）中引入伪迹，从而干扰对潜在心律的诊断。因此，为了通过自动体外除颤器（AED）进行可靠的电击建议分析，必须停止心肺复苏。在心肺复苏期间检测室颤（VF）将使心肺复苏能够在AED心律分析期间继续进行，从而增加复苏成功的可能性。本研究提出了一种新的自适应滤波方法来净化心电图。该方法包括一个滤波器，该滤波器仅使用商用AED通过标准贴片采集的体表心电图，使其特性适应信号的频谱内容。从实际院外干预中收集的一组200个室颤样本和25个心肺复苏伪迹样本用于测试该方法。在去除伪迹前后评估了电击建议算法的性能。将心肺复苏伪迹添加到心电图信号中，并测试了四种程度的干扰。平均灵敏度分别达到97.83%、98.27%、98.32%和98.02%，灵敏度分别提高了28.44%、49.75%、59.10%和64.25%，足以用于心肺复苏期间的心电图分析。尽管获得了令人满意和鼓舞人心的灵敏度值，但为了将这种伪迹抑制算法集成到当前的自动体外除颤器中，还需要进一步的临床和实验研究。
