Logo image
A new rhythm library for testing automatic external defibrillators: Performance of three devices
Journal article   Open access   Peer reviewed

A new rhythm library for testing automatic external defibrillators: Performance of three devices

Richard O Cummins, Kenneth R Stults, Bruce Haggar, Richard E Kerber, Sherrie Schaeffer and Donald D Brown
Journal of the American College of Cardiology, Vol.11(3), pp.597-602
03/1988
DOI: 10.1016/0735-1097(88)91537-9
PMID: 3343464
url
https://doi.org/10.1016/0735-1097(88)91537-9View
Published (Version of record) Open Access

Abstract

A library of arrhythmias obtained from patients with cardiac arrest was developed. Such a data base will permit both in vitro testing of the rhythm analysis system of automatic external defibrillators before clinical field trials are conducted and comparison of devices. Defibrillators equipped with voice/electrocardiographic tape recorders and used in the prehospital defibrillation programs in Iowa and King County, Washington provided the rhythm source. From these recordings, segments of ventricular fibrillation with minimal artifact and a duration of ≥6 s were selected. Segment of ventricular fibrillation (n = 102) were categorized by average peak amplitude as fine (1 to <3 mm), medium (3 to <7 mm), coarse (7 to <12 mm) and extra coarse (≥12 mm), and transcribed onto high fidelity videocassette tapes. Nonventricular fibrillation cardiac arrest rhythms (n = 144), which included wide complex idioventricular rhythms, ventricular and supraventricular tachycardias, asystole and artifact, were also transcribed. Automatic external defibrillators developed by three manufacturers reached a treat (shock) decision on 88 to 93% of the ventricular fibrillation rhythms and on 5 to 10% of the nonventricular fibrillation rhythms. The latter decisions were defined as false positive, though for many rapid nonventricular fibrillation rhythms, countershock may be the appropriate treatment response. There were no statistically significant differences among the three devices in the shock/no shock decisions. A variety of ventricular fibrillation arrhythmias and terminology to express the preclinical performance of automatic external defibrillators are defined. Three commercially available automatic external defibrillators appear to successfully identify ventricular fibrillation and nonventricular fibrillation rhythms. Although an arrhythmia library cannot substitute for clinical field trials, it may facilitate objective and consistent evaluation of automatic external defibrillator detection algorithms. Such evaluations should precede clinical use of new devices.

Details

Metrics

Logo image