Murray A, Clayton R H, Campbell R W
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, UK.
Resuscitation. 1993 Oct;26(2):163-72. doi: 10.1016/0300-9572(93)90175-p.
The sensitivity and specificity of ventricular fibrillation (VF) detection in three semi-automatic defibrillators (Laerdal Heartstart 3000, Spacelabs First Medic 610, Physio-Control Lifepak 300) and two advisory defibrillators (S&W DMS940, Marquette Responder 1500) were assessed with 25 ECG recordings, each of length 40 s. Of the 25 ECG recordings, 12 contained VF requiring defibrillation, three contained a tachyarrhythmia with a waveform similar to VF but which self-terminated, and 10 were selected from abnormal rhythms and artefacts which contained some features similar to VF. Sensitivity was assessed from the VF data. Specificity was assessed from both the rhythm preceding VF or the tachyarrhythmias, and from the VF-like data. The response to a changing rhythm was assessed from the self-terminating tachyarrhythmias. Each recording was replayed to the defibrillators at three signal amplitudes (normal, half and double). For each defibrillator, requests to check the patient and advice to shock were noted separately. The sensitivity for recommending a shock when a shock was required varied from 81 to 97%. The sensitivity for drawing attention to VF, either through requesting the patient to be checked or advising a shock, varied from 92% to 100%. There were no false detections in the rhythms preceding VF or the tachyarrhythmias (specificity with good quality signals 100%). The specificity with the VF-like data ranged from 63 to 90% for recommending a shock, and from 63% to 70% for requesting the patient be checked or shocked. There was no difference between the defibrillators for VF detection, but there was a significant difference between the semi-automatic and advisory defibrillators (P < 0.05) for the specificity of the final recommendation.
利用25份时长均为40秒的心电图记录，对三款半自动除颤器（Laerdal Heartstart 3000、Spacelabs First Medic 610、Physio-Control Lifepak 300）和两款咨询式除颤器（S&W DMS940、Marquette Responder 1500）检测室颤（VF）的敏感性和特异性进行了评估。在这25份心电图记录中，12份包含需要除颤的室颤，3份包含波形与室颤相似但可自行终止的快速心律失常，10份选自包含一些与室颤相似特征的异常节律和伪迹。室颤检测的敏感性根据室颤数据进行评估。特异性则根据室颤或快速心律失常之前的节律以及类似室颤的数据进行评估。从可自行终止的快速心律失常评估对变化节律的反应。每份记录以三种信号幅度（正常、一半和两倍）重放给除颤器。对于每台除颤器，分别记录检查患者的请求和电击建议。在需要电击时推荐电击的敏感性从81%到97%不等。通过请求检查患者或建议电击来引起对室颤关注的敏感性从92%到100%不等。在室颤或快速心律失常之前的节律中没有误检测（高质量信号的特异性为100%）。对于推荐电击，类似室颤数据的特异性范围为63%到90%，对于请求检查或电击患者，特异性范围为63%到70%。在室颤检测方面，各除颤器之间没有差异，但在最终建议的特异性方面，半自动和咨询式除颤器之间存在显著差异（P < 0.05）。
