Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads

Erik Alonso, Elisabete Aramendi, Mohamud Daya, Unai Irusta, Beatriz Chicote, James K. Russell, Larisa G. Tereshchenko

Research output: Contribution to journalArticle

Abstract

Aim: To develop and evaluate a method to detect circulation in the presence of organized rhythms (ORs) during resuscitation using signals acquired by defibrillation pads. Methods: Segments containing electrocardiogram (ECG) and thoracic impedance (TI) signals free of artifacts were used. The ECG corresponded to ORs classified as pulseless electrical activity (PEA) or pulse-generating rhythm (PR). A first dataset containing 1091 segments was split into training and test sets to develop and validate the circulation detector. The method processed ECG and TI to obtain the impedance circulation component (ICC). Morphological features were extracted from ECG and ICC, and combined into a classifier to discriminate between PEA and PR. The performance of the method was evaluated in terms of sensitivity (PR) and specificity (PEA). A second dataset (86 segments from different patients) was used to assess two application of the method: confirmation of arrest by recognizing absence of circulation during ORs and detection of return of spontaneous circulation (ROSC) during resuscitation. In both cases, time to confirmation of arrest/ROSC was determined. Results: The method showed a sensitivity/specificity of 92.1%/90.3% and 92.2%/91.9% for training and test sets respectively. The method confirmed cardiac arrest with a specificity of 93.3% with a median delay of 0 s after the first OR annotation. ROSC was detected with a sensitivity of 94.4% with a median delay of 57. s from ROSC onset. Conclusion: The method showed good performance, and can be reliably used to distinguish perfusing from non-perfusing ORs.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalResuscitation
Volume99
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Electric Impedance
Electrocardiography
Thorax
Pulse
Resuscitation
Heart Arrest
Artifacts
Sensitivity and Specificity

Keywords

  • Circulation detection
  • Defibrillator
  • Pulse
  • Pulse-generating rhythm
  • Pulseless electrical activity
  • Thoracic impedance

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Alonso, E., Aramendi, E., Daya, M., Irusta, U., Chicote, B., Russell, J. K., & Tereshchenko, L. G. (2016). Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads. Resuscitation, 99, 56-62. https://doi.org/10.1016/j.resuscitation.2015.11.014

Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads. / Alonso, Erik; Aramendi, Elisabete; Daya, Mohamud; Irusta, Unai; Chicote, Beatriz; Russell, James K.; Tereshchenko, Larisa G.

In: Resuscitation, Vol. 99, 01.02.2016, p. 56-62.

Research output: Contribution to journalArticle

Alonso, E, Aramendi, E, Daya, M, Irusta, U, Chicote, B, Russell, JK & Tereshchenko, LG 2016, 'Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads', Resuscitation, vol. 99, pp. 56-62. https://doi.org/10.1016/j.resuscitation.2015.11.014
Alonso, Erik ; Aramendi, Elisabete ; Daya, Mohamud ; Irusta, Unai ; Chicote, Beatriz ; Russell, James K. ; Tereshchenko, Larisa G. / Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads. In: Resuscitation. 2016 ; Vol. 99. pp. 56-62.
@article{345c70cd1aea4f9086e40bc7a5cb7fd4,
title = "Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads",
abstract = "Aim: To develop and evaluate a method to detect circulation in the presence of organized rhythms (ORs) during resuscitation using signals acquired by defibrillation pads. Methods: Segments containing electrocardiogram (ECG) and thoracic impedance (TI) signals free of artifacts were used. The ECG corresponded to ORs classified as pulseless electrical activity (PEA) or pulse-generating rhythm (PR). A first dataset containing 1091 segments was split into training and test sets to develop and validate the circulation detector. The method processed ECG and TI to obtain the impedance circulation component (ICC). Morphological features were extracted from ECG and ICC, and combined into a classifier to discriminate between PEA and PR. The performance of the method was evaluated in terms of sensitivity (PR) and specificity (PEA). A second dataset (86 segments from different patients) was used to assess two application of the method: confirmation of arrest by recognizing absence of circulation during ORs and detection of return of spontaneous circulation (ROSC) during resuscitation. In both cases, time to confirmation of arrest/ROSC was determined. Results: The method showed a sensitivity/specificity of 92.1{\%}/90.3{\%} and 92.2{\%}/91.9{\%} for training and test sets respectively. The method confirmed cardiac arrest with a specificity of 93.3{\%} with a median delay of 0 s after the first OR annotation. ROSC was detected with a sensitivity of 94.4{\%} with a median delay of 57. s from ROSC onset. Conclusion: The method showed good performance, and can be reliably used to distinguish perfusing from non-perfusing ORs.",
keywords = "Circulation detection, Defibrillator, Pulse, Pulse-generating rhythm, Pulseless electrical activity, Thoracic impedance",
author = "Erik Alonso and Elisabete Aramendi and Mohamud Daya and Unai Irusta and Beatriz Chicote and Russell, {James K.} and Tereshchenko, {Larisa G.}",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.resuscitation.2015.11.014",
language = "English (US)",
volume = "99",
pages = "56--62",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Circulation detection using the electrocardiogram and the thoracic impedance acquired by defibrillation pads

AU - Alonso, Erik

AU - Aramendi, Elisabete

AU - Daya, Mohamud

AU - Irusta, Unai

AU - Chicote, Beatriz

AU - Russell, James K.

AU - Tereshchenko, Larisa G.

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Aim: To develop and evaluate a method to detect circulation in the presence of organized rhythms (ORs) during resuscitation using signals acquired by defibrillation pads. Methods: Segments containing electrocardiogram (ECG) and thoracic impedance (TI) signals free of artifacts were used. The ECG corresponded to ORs classified as pulseless electrical activity (PEA) or pulse-generating rhythm (PR). A first dataset containing 1091 segments was split into training and test sets to develop and validate the circulation detector. The method processed ECG and TI to obtain the impedance circulation component (ICC). Morphological features were extracted from ECG and ICC, and combined into a classifier to discriminate between PEA and PR. The performance of the method was evaluated in terms of sensitivity (PR) and specificity (PEA). A second dataset (86 segments from different patients) was used to assess two application of the method: confirmation of arrest by recognizing absence of circulation during ORs and detection of return of spontaneous circulation (ROSC) during resuscitation. In both cases, time to confirmation of arrest/ROSC was determined. Results: The method showed a sensitivity/specificity of 92.1%/90.3% and 92.2%/91.9% for training and test sets respectively. The method confirmed cardiac arrest with a specificity of 93.3% with a median delay of 0 s after the first OR annotation. ROSC was detected with a sensitivity of 94.4% with a median delay of 57. s from ROSC onset. Conclusion: The method showed good performance, and can be reliably used to distinguish perfusing from non-perfusing ORs.

AB - Aim: To develop and evaluate a method to detect circulation in the presence of organized rhythms (ORs) during resuscitation using signals acquired by defibrillation pads. Methods: Segments containing electrocardiogram (ECG) and thoracic impedance (TI) signals free of artifacts were used. The ECG corresponded to ORs classified as pulseless electrical activity (PEA) or pulse-generating rhythm (PR). A first dataset containing 1091 segments was split into training and test sets to develop and validate the circulation detector. The method processed ECG and TI to obtain the impedance circulation component (ICC). Morphological features were extracted from ECG and ICC, and combined into a classifier to discriminate between PEA and PR. The performance of the method was evaluated in terms of sensitivity (PR) and specificity (PEA). A second dataset (86 segments from different patients) was used to assess two application of the method: confirmation of arrest by recognizing absence of circulation during ORs and detection of return of spontaneous circulation (ROSC) during resuscitation. In both cases, time to confirmation of arrest/ROSC was determined. Results: The method showed a sensitivity/specificity of 92.1%/90.3% and 92.2%/91.9% for training and test sets respectively. The method confirmed cardiac arrest with a specificity of 93.3% with a median delay of 0 s after the first OR annotation. ROSC was detected with a sensitivity of 94.4% with a median delay of 57. s from ROSC onset. Conclusion: The method showed good performance, and can be reliably used to distinguish perfusing from non-perfusing ORs.

KW - Circulation detection

KW - Defibrillator

KW - Pulse

KW - Pulse-generating rhythm

KW - Pulseless electrical activity

KW - Thoracic impedance

UR - http://www.scopus.com/inward/record.url?scp=84954311207&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84954311207&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2015.11.014

DO - 10.1016/j.resuscitation.2015.11.014

M3 - Article

VL - 99

SP - 56

EP - 62

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -