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European Heart Journal 1992 13(5):608-615;
Copyright © 1992 by the European Society of Cardiology.
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© 1992 The European Society of Cardiology

The accuracy of decision-making of a semi-automatic defibrillator during cardiac arrest

W. DICKEY, G. W. N. DALZELL, J. MCC. ANDERSON* and A. A. J. ADGEY

Regional Medical Cardiology Centre, Royal Victoria Hospital Belfast BT12 6BA, N. Ireland
*Department of Bioengineering, University of Ulster Jordanstown, N. Ireland

Received 4 January 1991; revised 22 May 1991; .

Correspondence: Dr A. A. J. Adgey, Regional Medical Cardiology Centre, Royal Victoria Hospital, Belfast BT12 6BA, N. Ireland.

Abstract

The accuracy of decision-making of a semi-automatic defibrillator was assessed at 57 cardiac arrests in 55 patients. The initial rhythm was ventricular fibrillation at 40 arrests and was correctly identified in 37 (sensitivity 92.5%). In theother 17 arrests initial rhythms were not ventricular fibrillation and 16 were correctly identified (specificity 94%). Continuous electrocardiographic recordings of the arrests were analysed in 8–12 s segments: of 432 segments showing ventricular fibrillation, 352 were correctly identified (sensitivity 81%); 3895 of 4139 segments showing rhythms other than ventricular fibrillation were correctly identified (specificity 94%). The percentage accuracy of detection of ventricular fibrillation varied from 0–100% (mean 91%) and for non-ventricular fibrillation from 51–100% (mean 92%). When 104 segments of ventricular fibrillation and 470 segments of non-ventricular fibrillation with cardiopulmonary resuscitation artefact were excluded from the analysis, a sensitivity of 91% and specificity of 96% were obtained. Thus the detection of cardiac arrest rhythms using a microprocessor based detection system for patients with cardiac arrest has a high sensitivity for ventricular fibrillation and specificity for non-ventricular fibrillation.

Key Words: Semi-automatic defibrillator • ventricular fibrillation • non-ventricular fibrillation • cardiac arrests


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