Bench study of the accuracy of a commercial AED arrhythmia analysis algorithm in the presence of electromagnetic interferences
Bench study of the accuracy of a commercial AED arrhythmia analysis algorithm in the presence of electromagnetic interferences
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DOI：
10.1088/0967-3334/30/7/012
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发表时间：
2009-07-01
影响因子：
3.2
通讯作者：
Didon, Jean-Philippe
中科院分区：
文献类型：
--
作者：
Jekova, Irena;Krasteva, Vessela;Didon, Jean-Philippe
本文介绍了一个商业自动体外除颤器（AED）的实验室研究。目的是评价除颤咨询系统的性能及其对中心频率为16.7、50和60 Hz的电磁干扰（EMI）的鲁棒性。电击咨询系统使用两个50和60 Hz带通滤波器、一个用于识别和抑制16.7 Hz干扰的自适应滤波器以及一种基于形态和频率心电图参数进行心律失常分析的软件技术。测试过程包括来自国际公认的MIT-VFDB ECG数据库的无噪声ECG条带，其叠加有模拟EMI伪影并提供给嵌入在真实的AED中的电击咨询系统。在特别考虑EMI频率（15.7-17.4、47-52、58-62 Hz）和振幅（1和8 mV）允许变化的情况下进行测量，以优化外部有效性。使用美国心脏协会（AHA）关于心律失常分析性能的建议报告准确性。在无伪影信号的情况下，灵敏度和特异性均超过了AHA性能目标：室颤（VF）为99%，快速室性心动过速（VT）为98%，缓慢VT为90%，正常窦性心律为100%，心搏停止为100%，其他不可电击心律为99%。在存在EMI的情况下，在低信噪比和极端频率的某些特定情况下，某些不可电击节律（NSR，N）的特异性可能会受到影响，导致特异性下降不超过7%。在存在任何类型的16.7、50或60 Hz EMI模拟伪影的情况下，心搏停止的特异性以及VF和快速VT的灵敏度显示达到了非噪声信号所需的灵敏度的等效性。总之，我们证明了在真实的AED中工作的电击咨询系统根据AHA建议准确地操作，没有伪影并且存在EMI。在低信噪比或某些极端频率设置的情况下，结果可能会受到特异性的影响。
This paper presents a bench study on a commercial automated external defibrillator (AED). The objective was to evaluate the performance of the defibrillation advisory system and its robustness against electromagnetic interferences (EMI) with central frequencies of 16.7, 50 and 60 Hz. The shock advisory system uses two 50 and 60 Hz band-pass filters, an adaptive filter to identify and suppress 16.7 Hz interference, and a software technique for arrhythmia analysis based on morphology and frequency ECG parameters. The testing process includes noise-free ECG strips from the internationally recognized MIT-VFDB ECG database that were superimposed with simulated EMI artifacts and supplied to the shock advisory system embedded in a real AED. Measurements under special consideration of the allowed variation of EMI frequency (15.7-17.4, 47-52, 58-62 Hz) and amplitude (1 and 8 mV) were performed to optimize external validity. The accuracy was reported using the American Heart Association (AHA) recommendations for arrhythmia analysis performance. In the case of artifact-free signals, the AHA performance goals were exceeded for both sensitivity and specificity: 99% for ventricular fibrillation (VF), 98% for rapid ventricular tachycardia (VT), 90% for slow VT, 100% for normal sinus rhythm, 100% for asystole and 99% for other non-shockable rhythms. In the presence of EMI, the specificity for some non-shockable rhythms (NSR, N) may be affected in some specific cases of a low signal-to-noise ratio and extreme frequencies, leading to a drop in the specificity with no more than 7% point. The specificity for asystole and the sensitivity for VF and rapid VT in the presence of any kind of 16.7, 50 or 60 Hz EMI simulated artifact were shown to reach the equivalence of sensitivity required for non-noisy signals. In conclusion, we proved that the shock advisory system working in a real AED operates accurately according to the AHA recommendations without artifacts and in the presence of EMI. The results may be affected for specificity in the case of a low signal-to-noise ratio or in some extreme frequency setting.