Ventricular Fibrillation Waveform Measures Combined with Prior Shock Outcome Predict Defibrillation Success During Cardiopulmonary Resuscitation

Overview

Journal J Electrocardiol

Specialty Cardiology & Vascular Diseases

Date 2017 Sep 13

PMID 28893389

Citations 13

Authors

Jason Coult

Heemun Kwok

Lawrence Sherman

Jennifer Blackwood

Peter J Kudenchuk

Thomas D Rea

Affiliations

Soon will be listed here.

Abstract

Aim: Amplitude Spectrum Area (AMSA) and Median Slope (MS) are ventricular fibrillation (VF) waveform measures that predict defibrillation shock success. Cardiopulmonary resuscitation (CPR) obscures electrocardiograms and must be paused for analysis. Studies suggest waveform measures better predict subsequent shock success when combined with prior shock success. We determined whether this relationship applies during CPR.

Methods: AMSA and MS were calculated from 5-second pre-shock segments with and without CPR, and compared to logistic models combining each measure with prior return of organized rhythm (ROR).

Results: VF segments from 692 patients were analyzed during CPR before 1372 shocks and without CPR before 1283 shocks. Combining waveform measures with prior ROR increased areas under receiver operating characteristic curves for AMSA/MS with CPR (0.66/0.68 to 0.73/0.74, p<0.001) and without CPR (0.71/0.72 to 0.76/0.76, p<0.001).

Conclusions: Prior ROR improves prediction of shock success during CPR, and may enable waveform measure calculation without chest compression pauses.

Citing Articles

Amplitude spectral area of ventricular fibrillation can discriminate survival of patients with out-of-hospital cardiac arrest.

Gentile F, Wik L, Isasi I, Baldi E, Aramendi E, Steen-Hansen J Front Cardiovasc Med. 2024; 11:1336291.

PMID: 38380178 PMC: 10876863. DOI: 10.3389/fcvm.2024.1336291.

Different Ventricular Fibrillation Types in Low-Dimensional Latent Spaces.

Bernal Onate C, Melgarejo Meseguer F, Carrera E, Sanchez Munoz J, Garcia Alberola A, Rojo Alvarez J Sensors (Basel). 2023; 23(5).

PMID: 36904731 PMC: 10006875. DOI: 10.3390/s23052527.

Targeted Delivery of Electrical Shocks and Epinephrine, Guided by Ventricular Fibrillation Amplitude Spectral Area, Reduces Electrical and Adrenergic Myocardial Burden, Improving Survival in Swine.

Aiello S, Mendelson J, Baetiong A, Radhakrishnan J, Gazmuri R J Am Heart Assoc. 2021; 10(23):e023956.

PMID: 34743550 PMC: 9075377. DOI: 10.1161/JAHA.121.023956.

Electrocardiographic recording direction impacts ventricular fibrillation waveform measurements: A potential pitfall for VF-waveform guided defibrillation protocols.

Thannhauser J, Nas J, Vart P, Smeets J, de Boer M, van Royen N Resusc Plus. 2021; 6:100114.

PMID: 34223374 PMC: 8244524. DOI: 10.1016/j.resplu.2021.100114.

[Adult advanced life support].

Soar J, Bottiger B, Carli P, Couper K, Deakin C, Djarv T Notf Rett Med. 2021; 24(4):406-446.

PMID: 34121923 PMC: 8185697. DOI: 10.1007/s10049-021-00893-x.

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