Amplitude spectrum area: measuring the probability of successful defibrillation as applied to human data.
Amplitude spectrum area: measuring the probability of successful defibrillation as applied to human data.
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DOI：
10.1097/01.ccm.0000134353.55378.88
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发表时间：
2004-09-01
影响因子：
8.8
通讯作者：
Weil, Max Harry
中科院分区：
文献类型：
--
作者：
Young, Clayton;Bisera, Joe;Weil, Max Harry
目的：我们的研究目的是检查心电图预测，幅度谱面积（AMSA），心脏骤停的人的除颤电击的最佳时机的有效性。基于室颤电位的频谱特征，我们检查了成功转换为有组织的可行心律的概率，包括自主循环的恢复。目的是预测成功除颤的可能性，从而通过减少胸外按压的中断和减少由于重复高电流电击引起的电诱导心肌损伤来改善结果。院外心脏骤停的受害者。干预：心电图记录的迭代，代表了46名因心室纤颤而心脏骤停的受害者用自动体外除颤器进行108次除颤尝试时的导联2等效记录。测量和主要结果：使用AMSA算法分析在电击前立即记录的3秒室颤。AMSA表示基于3和48 Hz之间的加权频谱的幅度之和的数值。AMSA值越大，室颤逆转的概率越大。当AMSA值> 13. 0 mV-Hz时，成功除颤的敏感性为.91，特异性为.94。结论：AMSA预测电除颤成功具有较高的特异性。因此，AMSA用于最小化心前区按压的中断和由重复和无效电击递送引起的心肌损伤。
OBJECTIVE: The objective of our study was to examine the effectiveness of an electrocardiographic predictor, amplitude spectral area (AMSA), for the optimal timing of defibrillation shocks in human victims of cardiac arrest. Based on the spectral characteristics of ventricular fibrillation potentials, we examined the probability of successful conversion to an organized viable rhythm, including the return of spontaneous circulation. The incentive was to predict the likelihood of successful defibrillation and thereby improve outcomes by minimizing interruptions in chest compression and minimizing electrically induced myocardial injury due to repetitive high-current shocks.DESIGN: Observational study on human electrocardiographic recordings during cardiopulmonary resuscitation.SETTING: Medical research laboratory of a university-affiliated research and educational institute.PATIENTS: Victims of out-of-hospital cardiac arrest.INTERVENTIONS: Iteration of electrocardiographic records, representing lead 2 equivalent recordings on 108 defibrillation attempts with an automated external defibrillator, of 46 victims of cardiac arrest due to ventricular fibrillation.MEASUREMENTS AND MAIN RESULTS: Three seconds of ventricular fibrillation, recorded immediately preceding delivery of a shock, were analyzed utilizing the AMSA algorithm. AMSA represents a numerical value based on the sum of the magnitude of the weighted frequency spectrum between 3 and 48 Hz. The greater the AMSA value, the greater was the probability of reversal of ventricular fibrillation. At an AMSA value of >13.0 mV-Hz, successful defibrillation yielded a sensitivity of .91 and a specificity of .94.CONCLUSION: AMSA predicts the success of electrical defibrillation with high specificity. AMSA therefore serves to minimize interruptions of precordial compression and the myocardial damage caused by delivery of repetitive and ineffective electrical shocks.