Electronics and Telecommunications Department, University of the Basque Country, Alameda Urquijo S/N, 48013 Bilbao, Spain.
Resuscitation. 2012 Sep;83(9):1090-7. doi: 10.1016/j.resuscitation.2012.01.032. Epub 2012 Feb 6.
To design the core algorithm of a high-temporal resolution rhythm analysis algorithm for automated external defibrillators (AEDs) valid for adults and children. Records from adult and paediatric patients were used all together to optimize and test the performance of the algorithm.
A total of 574 shockable and 1126 nonshockable records from 1379 adult patients, and 57 shockable and 503 nonshockable records from 377 children aged between 1 and 8 years were used. The records were split into two groups for development and testing. The core algorithm analyses ECG segments of 3.2s duration and classifies the segments as nonshockable or likely shockable combining a time, slope and frequency domain analysis to detect normally conducted QRS complexes.
The algorithm correctly identified 98% of nonshockable segments, 97.5% in adults and 98.4% in children, and identified 99.5% of shockable segments as likely shockable, 100% in adults and 96% in children. When likely shockable segments were further analysed in terms of regularity, spectral content and heart rate to form a complete rhythm analysis algorithm the overall specificity increased to 99.6% and the sensitivity was 99.1%.
Paediatric and adult rhythms can be accurately diagnosed using 3.2s ECG segments. A single algorithm safe for children and adults can simplify AED use, and its high temporal resolution shortens pre-shock pauses which may contribute to improve resuscitation outcome.
设计一种适用于成人和儿童的自动体外除颤器（AED）的高时间分辨率节律分析算法的核心算法。使用来自成人和儿科患者的记录来优化和测试算法的性能。
总共使用了来自 1379 名成年患者的 574 个可电击和 1126 个不可电击记录，以及来自 377 名 1 至 8 岁儿童的 57 个可电击和 503 个不可电击记录。记录被分为两组进行开发和测试。核心算法分析 3.2 秒持续时间的 ECG 段，并结合时间、斜率和频域分析将段分类为不可电击或可能电击，以检测正常传导的 QRS 复合体。
该算法正确识别了 98%的不可电击段，成人和儿童分别为 97.5%和 98.4%，识别了 99.5%的可电击段为可能电击，成人和儿童均为 100%。当进一步分析可能电击段的规则性、频谱内容和心率以形成完整的节律分析算法时，整体特异性增加到 99.6%，敏感性为 99.1%。
可以使用 3.2 秒 ECG 段准确诊断儿科和成人节律。一种适用于儿童和成人的单一算法可以简化 AED 的使用，其高时间分辨率缩短了电击前的暂停时间，这可能有助于提高复苏效果。
