Shock advisory system with minimal delay triggering after end of chest compressions: Accuracy and gained hands-off time

Didon, Jean-Philippe; Krasteva, Vessela; Ménétré, Sarah; Stoyanov, Todor; Jekova, Irena

doi:10.1016/S0300-9572(11)70145-9

« Previous Next »Resuscitation
Volume 82, Supplement 2 , Pages S8-S15, December 2011

Shock advisory system with minimal delay triggering after end of chest compressions: Accuracy and gained hands-off time

Jean-Philippe Didon
- Schiller Médical SAS, 4 rue L. Pasteur, F-67160 Wissembourg, France
- Address for correspondence: Jean-Philippe Didon, PhD, Schiller Médical SAS, 4 rue L. Pasteur, ZAE Sud BP 90050, F-67160 Wissembourg, France Cedex. Tel.: +33 (0)3 88 63 36 28; fax: +33 (0)3 88 63 36 49
Vessela Krasteva
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl 105, 1113 Sofia, Bulgaria
Sarah Ménétré
- Schiller Médical SAS, 4 rue L. Pasteur, F-67160 Wissembourg, France
Todor Stoyanov
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl 105, 1113 Sofia, Bulgaria
Irena Jekova
- Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl 105, 1113 Sofia, Bulgaria

Abstract

Aims

Shortening hands-off intervals can improve benefits from defibrillation. This study presents the performance of a shock advisory system (SAS), which aims to decrease the pre-shock pauses by triggering fast rhythm analysis at minimal delay after end of chest compressions (CC).

Methods

The SAS is evaluated on a database of 1301 samples from 311 out-of-hospital cardiac arrests (OHCA) from automated external defibrillators (AEDs). The following rhythms are identified: 788 asystoles (ASYS), 20 normal sinus rhythms (NSR), 394 other non-shockable rythms (ONS), 81 ventricular fibrillations (VF), 18 rapid ventricular tachycardias (VThi). SAS is launched in two-stages: first stage for accurate detection of actual end of CC (ReEoCC); second stage for early “Shock”/“No-Shock” decision by using all available artifact-free ECG signals after REoCC during 3, 5, 7 s.

Results

Performance of the presented SAS versus AEDs is compared. The median hands-off time gained from earlier starting of ECG analysis is 5.8 s and for earlier shock advice is 12.5 s to 8.5 s when SAS rhythm analysis lasts 3 s to 7 s. The SAS accuracy at 3–7 s is: specificity 97.7–98.9% (ASYS), 100–100% (NSR), 98.5–99.2% (ONS); sensitivity 91.4–98.8% (VF), 88.9–96.7% (VThi).

Conclusion

This study indicates that shortening the pre-shock hands-off pause by more efficient management of the SAS process in AEDs is possible. For analysis duration of 5 s (7 s), the delay between the end of chest compressions and the shock advice can be reduced by 10.5 s (8.5 s) median, while AHA requirements for rhythm detection accuracy are met. The use of this solution in AEDs could provide more reliable rhythm analysis than methods applying filtering techniques during CC.

Keywords: Automated external defibrillator , Out-of-hospital cardiopulmonary resuscitation , Shortened pre-shock pause , ECG , rhythm analysis

No full text is available. To read the body of this article, please view the PDF online.