A Grouped Up-and-Down Method Used for Efficacy Comparison Between Two Different Defibrillation Waveforms
A Grouped Up-and-Down Method Used for Efficacy Comparison Between Two Different Defibrillation Waveforms
复制标题
两种不同除颤波形疗效比较的分组上下法
DOI：
10.1109/tbme.2015.2458976
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发表时间：
2016-02-01
影响因子：
4.6
通讯作者：
Li, Yongqin
中科院分区：
文献类型：
--
作者：
Jin, Danian;Wang, Jianjie;Li, Yongqin
电除颤，包括在除颤器的帮助下将治疗剂量的电流输送到除颤的心脏，仍然是治疗危及生命的心室颤动（VF）的唯一有效方法。然而，用于终止VF的电疗的功效高度依赖于所施加的波形。当开发新的除颤波形或技术时，需要准确评估其功效，并与使用中的波形或技术进行比较。比较除颤效果的常用方法是通过构建剂量反应曲线或使用升降法来估计和比较个体除颤阈值（DFT）。由于DFT是通过重复和顺序冲击计算的，因此每次测量和每个个体都存在变异性。这为配对比较带来了相当大的不确定性。本文提出了一种新的分组升降法，用于比较两种不同除颤波形或技术的除颤效果。两种常用的双相除颤波形的疗效进行了比较，在猪模型的心脏骤停使用开发的方法。实验结果表明，所提出的方法是更敏感的疗效比较，并需要更少的除颤尝试相比，传统的DFT方法。
Electrical defibrillation, which consists of delivering a therapeutic dose of the electrical current to the fibrillating heart with the aid of a defibrillator, is still the only effective way to treat life-threatening ventricular fibrillation (VF). However, the efficacy of electrical therapy for terminating VF is highly dependent on the waveform applied. When new defibrillation waveforms or techniques are developed, their efficacy needs to be accurately evaluated and compared to those in use. A common method for the comparison of defibrillation efficacy is to estimate and compare the individual defibrillation threshold (DFT) by constructing dose response curves or using an up-and-down method. Since DFT is calculated by repetitive and sequential shocks, there will be variability for each measurement and for each individual. This creates a considerable uncertainty for paired comparison. In this paper, a novel grouped up-and-down method is developed for the comparison of defibrillation efficacy between two different defibrillation waveforms or techniques. The efficacy of two commonly used biphasic defibrillation waveforms was compared in a porcine model of cardiac arrest using the developed method. Experimental results demonstrate that the proposed method is more sensitive for efficacy comparison and requires less defibrillation attempts compared with traditional DFT methods.