Heart Rhythm
Heart Rhythm
5 years ago

Cardiac rhythm analysis during ongoing cardiopulmonary resuscitation using the “Analysis During Compressions with Fast Reconfirmation” (ADC-FR) technology

Pauses in chest compressions (CCs) have a negative association with survival from cardiac arrest (CA). 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 2,701 out-of-hospital CAs. Methods The ADC-FR algorithm generated a total of 7,264 advisories, of which 3,575 were randomly assigned to a development dataset and 3,689 to a test one. 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-min CPR interval, a 3 sec reconfirmation analysis is performed using the artifact-free ECG to confirm the shock/no-shock advisory. Sensitivity and specificity of the ADC-FR algorithm in correctly identifying shockable/non-shockable rhythms during CCs were calculated. Results In both the datasets, 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 dataset, and 95% and 99% for the test dataset. Conclusion The ADC-FR algorithm is highly accurate in discriminating shockable and non-shockable rhythms and can be used to reduce CC pauses.

Publisher URL: www.sciencedirect.com/science

DOI: S1547527117310822

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