Diagnostic Accuracy of Commercially Available Automated External Defibrillators

Background Although automated external defibrillators (AEDs) have contributed to a better survival of out‐of‐hospital cardiac arrests, there have been reports of their malfunctioning. We investigated the diagnostic accuracy of commercially available AEDs using surface ECGs of ventricular fibrillatio...

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Main Authors: Takahiko Nishiyama, Ako Nishiyama, Masachika Negishi, Shin Kashimura, Yoshinori Katsumata, Takehiro Kimura, Nobuhiro Nishiyama, Yoko Tanimoto, Yoshiyasu Aizawa, Hideo Mitamura, Keiichi Fukuda, Seiji Takatsuki
Format: Article
Language:English
Published: Wiley 2015-12-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
Subjects:
Online Access:https://doi.org/10.1161/JAHA.115.002465
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author Takahiko Nishiyama
Ako Nishiyama
Masachika Negishi
Shin Kashimura
Yoshinori Katsumata
Takehiro Kimura
Nobuhiro Nishiyama
Yoko Tanimoto
Yoshiyasu Aizawa
Hideo Mitamura
Keiichi Fukuda
Seiji Takatsuki
author_facet Takahiko Nishiyama
Ako Nishiyama
Masachika Negishi
Shin Kashimura
Yoshinori Katsumata
Takehiro Kimura
Nobuhiro Nishiyama
Yoko Tanimoto
Yoshiyasu Aizawa
Hideo Mitamura
Keiichi Fukuda
Seiji Takatsuki
author_sort Takahiko Nishiyama
collection DOAJ
description Background Although automated external defibrillators (AEDs) have contributed to a better survival of out‐of‐hospital cardiac arrests, there have been reports of their malfunctioning. We investigated the diagnostic accuracy of commercially available AEDs using surface ECGs of ventricular fibrillation (VF), ventricular tachycardia (VT), and supraventricular tachycardia (SVT). Methods and Results ECGs(VF 31, VT 48, SVT 97) were stored during electrophysiological studies and transmitted to 4 AEDs, the LifePak CR Plus (CR Plus), HeartStart FR3 (FR3), and CardioLife AED‐2150 (CL2150) and ‐9231 (CL9231), through the pad electrode cables. For VF, the CL2150 and CL9231 advised shocks in all cases, and the CR Plus and FR3 advised shocks in all but one VF case. For VTs faster than 180 bpm, the ratios for advising shocks were 79%, 36%, 89%, and 96% for the CR Plus, FR3, CL2150, and CL9231, respectively. The FR3 and CR Plus did not advise shocks for narrow QRS SVTs, whereas the CL9231 tended to treat high‐rate tachycardias faster than 180 bpm even with narrow QRS complexes. The characteristics of the shock advice for the FR3 differed from that for the CL9231 (kappa coefficient [κ]=0.479, P<0.001), and the CR Plus and CL2150 had characteristics somewhere between the 2 former AEDs (κ=0.818, P<0.001). Conclusions Commercially available AEDs diagnosed VF almost always correctly. For VT and SVT diagnoses, a discrepancy was evident among the 4 investigated AEDs. The differences in the arrhythmia diagnosis algorithms for differentiating SVT from VT were thought to account for these differences.
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spelling doaj.art-93b72b604a1f449190e144ec60837eb12022-12-21T20:00:56ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802015-12-01412n/an/a10.1161/JAHA.115.002465Diagnostic Accuracy of Commercially Available Automated External DefibrillatorsTakahiko Nishiyama0Ako Nishiyama1Masachika Negishi2Shin Kashimura3Yoshinori Katsumata4Takehiro Kimura5Nobuhiro Nishiyama6Yoko Tanimoto7Yoshiyasu Aizawa8Hideo Mitamura9Keiichi Fukuda10Seiji Takatsuki11Department of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Medical Engineering Keio University School of Medicine Tokyo JapanDepartment of Medical Engineering Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanCardiovascular Center Tachikawa Hospital Federation of National Public Service Personnel Mutual Aid Associations Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanDepartment of Cardiology Keio University School of Medicine Tokyo JapanBackground Although automated external defibrillators (AEDs) have contributed to a better survival of out‐of‐hospital cardiac arrests, there have been reports of their malfunctioning. We investigated the diagnostic accuracy of commercially available AEDs using surface ECGs of ventricular fibrillation (VF), ventricular tachycardia (VT), and supraventricular tachycardia (SVT). Methods and Results ECGs(VF 31, VT 48, SVT 97) were stored during electrophysiological studies and transmitted to 4 AEDs, the LifePak CR Plus (CR Plus), HeartStart FR3 (FR3), and CardioLife AED‐2150 (CL2150) and ‐9231 (CL9231), through the pad electrode cables. For VF, the CL2150 and CL9231 advised shocks in all cases, and the CR Plus and FR3 advised shocks in all but one VF case. For VTs faster than 180 bpm, the ratios for advising shocks were 79%, 36%, 89%, and 96% for the CR Plus, FR3, CL2150, and CL9231, respectively. The FR3 and CR Plus did not advise shocks for narrow QRS SVTs, whereas the CL9231 tended to treat high‐rate tachycardias faster than 180 bpm even with narrow QRS complexes. The characteristics of the shock advice for the FR3 differed from that for the CL9231 (kappa coefficient [κ]=0.479, P<0.001), and the CR Plus and CL2150 had characteristics somewhere between the 2 former AEDs (κ=0.818, P<0.001). Conclusions Commercially available AEDs diagnosed VF almost always correctly. For VT and SVT diagnoses, a discrepancy was evident among the 4 investigated AEDs. The differences in the arrhythmia diagnosis algorithms for differentiating SVT from VT were thought to account for these differences.https://doi.org/10.1161/JAHA.115.002465cardiopulmonary resuscitationdefibrillationfibrillationtachycardia
spellingShingle Takahiko Nishiyama
Ako Nishiyama
Masachika Negishi
Shin Kashimura
Yoshinori Katsumata
Takehiro Kimura
Nobuhiro Nishiyama
Yoko Tanimoto
Yoshiyasu Aizawa
Hideo Mitamura
Keiichi Fukuda
Seiji Takatsuki
Diagnostic Accuracy of Commercially Available Automated External Defibrillators
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiopulmonary resuscitation
defibrillation
fibrillation
tachycardia
title Diagnostic Accuracy of Commercially Available Automated External Defibrillators
title_full Diagnostic Accuracy of Commercially Available Automated External Defibrillators
title_fullStr Diagnostic Accuracy of Commercially Available Automated External Defibrillators
title_full_unstemmed Diagnostic Accuracy of Commercially Available Automated External Defibrillators
title_short Diagnostic Accuracy of Commercially Available Automated External Defibrillators
title_sort diagnostic accuracy of commercially available automated external defibrillators
topic cardiopulmonary resuscitation
defibrillation
fibrillation
tachycardia
url https://doi.org/10.1161/JAHA.115.002465
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