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Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators

Authors: Carlos Figuera; Unai Irusta; Eduardo Morgado; Elisabete Aramendi; Unai Ayala; Lars Wik; Jo Kramer-Johansen; +2 Authors

Machine Learning Techniques for the Detection of Shockable Rhythms in Automated External Defibrillators

Abstract

Early recognition of ventricular fibrillation (VF) and electrical therapy are key for the survival of out-of-hospital cardiac arrest (OHCA) patients treated with automated external defibrillators (AED). AED algorithms for VF-detection are customarily assessed using Holter recordings from public electrocardiogram (ECG) databases, which may be different from the ECG seen during OHCA events. This study evaluates VF-detection using data from both OHCA patients and public Holter recordings. ECG-segments of 4-s and 8-s duration were analyzed. For each segment 30 features were computed and fed to state of the art machine learning (ML) algorithms. ML-algorithms with built-in feature selection capabilities were used to determine the optimal feature subsets for both databases. Patient-wise bootstrap techniques were used to evaluate algorithm performance in terms of sensitivity (Se), specificity (Sp) and balanced error rate (BER). Performance was significantly better for public data with a mean Se of 96.6%, Sp of 98.8% and BER 2.2% compared to a mean Se of 94.7%, Sp of 96.5% and BER 4.4% for OHCA data. OHCA data required two times more features than the data from public databases for an accurate detection (6 vs 3). No significant differences in performance were found for different segment lengths, the BER differences were below 0.5-points in all cases. Our results show that VF-detection is more challenging for OHCA data than for data from public databases, and that accurate VF-detection is possible with segments as short as 4-s.

Keywords

hospital cardiac-arrest, Time Factors, Science, public-access defibrillation, hjerteinfarkt, tachycardia, Machine Learning, Automation, Electrocardiography, cardiopulmonary-resuscitation, wave-form, Humans, out-of-hospital cardiac arrest, ventricular-fibrillation, VDP::Teknologi: 500::Informasjons- og kommunikasjonsteknologi: 550, automatisert defibrillator, VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771, parameters, Q, R, surface ecg, ventricular fibrillation (VF), Databases as Topic, chest compression pauses, automated external defibrillators, Medicine, arrhythmia analysis algorithm, Algorithms, Out-of-Hospital Cardiac Arrest, Research Article, Defibrillators

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    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
58
Top 10%
Top 10%
Top 10%
Green
gold