Journal article
Sensitivity and specificity of an automated external defibrillator algorithm designed for pediatric patients
Resuscitation, Vol.76(2), pp.168-174
2008
DOI: 10.1016/j.resuscitation.2007.06.032
PMID: 17765384
Abstract
Electrocardiographic (ECG) rhythm analysis algorithms for cardiac rhythm analysis in automated external defibrillators (AEDs) have been tested against pediatric patient rhythms (patients ≤8 years old) using adult ECG algorithm criteria. However these adult algorithms may fail to detect non-shockable pediatric tachycardias because they do not account for the difference in the rates of normal sinus rhythm and typical tachyarrhythmias in childhood.
This study was designed to define shockable and non-shockable rhythm detection criteria specific to pediatric patients to create a pediatric rhythm database of annotated rhythms, to develop a pediatric-based AED rhythm analysis algorithm, and to test the algorithm's accuracy. Pediatric rhythm detection criteria were defined for coarse ventricular fibrillation, rapid ventricular tachycardia, and non-shockable rhythms, including pediatric supraventricular tachycardia. Pediatric rhythms were collected as sustained, classifiable, rhythms ≥9
s in length, and were annotated by pediatric electrophysiologists as clinically shockable or non-shockable based on pediatric criteria. Rhythms were placed into a pediatric rhythm database; each rhythm was converted to digitally accessible, public-domain, MIT rhythm data format. The database was used to evaluate a pediatric-based AED rhythm analysis algorithm.
Electrocardiographic rhythms from 198 children were recorded. There were 120 shockable rhythms from 49 patients (sensitivity; coarse ventricular fibrillation: 42 rhythms, 100%; rapid ventricular tachycardia: 78 rhythms, 94%), for combined sensitivity of 96.0% (115/120). There were 585 non-shockable rhythms from 155 patients (specificity normal sinus: 208 rhythms, 100%; asystole: 29 rhythms, 100%; supraventricular tachycardia: 161 rhythms, 99%; other arrhythmias: 187 rhythms, 100%), for combined specificity of 99.7% (583/585). Overall accuracy for shockable and non-shockable rhythms was 99.0% (702/709).
New pediatric rhythm detection criteria were defined and analysis based on these criteria demonstrated both high sensitivity (coarse ventricular fibrillation, rapid ventricular tachycardia) and high specificity (non-shockable rhythms, including supraventricular tachycardia). A pediatric-based AED can detect shockable rhythms correctly, making it safe and exceptionally effective for children.
Details
- Title: Subtitle
- Sensitivity and specificity of an automated external defibrillator algorithm designed for pediatric patients
- Creators
- Dianne L Atkins - Division of Pediatric Cardiology, University of Iowa, 200 Hawkins Drive, University of Iowa Children's Hospital, Iowa City, IA 52242, United StatesWilliam A Scott - Division of Cardiology, Department of Pediatrics, University of Texas Southwestern Medical Center at Dallas, Children's Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-9063, United StatesAndrew D Blaufox - Medical University of South Carolina, Children's Hospital, Charleston, SC, United StatesIan H Law - Division of Pediatric Cardiology, University of Iowa, 200 Hawkins Drive, University of Iowa Children's Hospital, Iowa City, IA 52242, United StatesMacdonald Dick II - Pediatric Cardiology, University of Michigan, C.S. Mott Children's Hospital, L1242 Box 0204 UMHS, Ann Arbor, MI 48109-2040, United StatesFrederick Geheb - ZOLL Medical Corporation, 269 Mill Road, Chelmsford, MA 01824-4105, United StatesJamil Sobh - ZOLL Medical Corporation, 269 Mill Road, Chelmsford, MA 01824-4105, United StatesJames E Brewer - ZOLL Medical Corporation, 269 Mill Road, Chelmsford, MA 01824-4105, United States
- Resource Type
- Journal article
- Publication Details
- Resuscitation, Vol.76(2), pp.168-174
- Publisher
- Elsevier Ireland Ltd
- DOI
- 10.1016/j.resuscitation.2007.06.032
- PMID
- 17765384
- ISSN
- 0300-9572
- eISSN
- 1873-1570
- Language
- English
- Date published
- 2008
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984093335102771
Metrics
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