Feasibility of shock advice analysis during CPR through removal of CPR artefacts from the human ECG

Part 5: Adult Basic Life Support

“…In 6 LOE 5 studies [191][192][193][194][195][196] using human-derived ECG recordings with actual or simulated CPR artifacts and 1 LOE 5 study in a swine model of VF, 197 the use of computerized algorithms that removed compression artifacts from the ECG during CPR reduced the accuracy of rhythm analysis relative to rhythm analysis during pauses. Sensitivity was between 90% and 98%, which would cause inappropriate prolongations in chest compression for shockable rhythms in up to 1 out of 10 patients.…”

Removal of CPR Artifacts From the Ventricular Fibrillation ECG by Adaptive Regression on Lagged Reference Signals

“…However, their VF signal model is more realistic than our white noise assumption. The research group of Eftestol, Husoy et al [5], [16], [17] applies an adaptive matching pursuit-like algorithm using multiple reference signals. Their CPR estimates are given by adaptively optimized linear combinations of past and current reference signal values, whereas our CPR estimates also include future values.…”

“…To investigate the feasibility of rhythm detection algorithms during CPR, nonshockable signals should also be included, cf. [17]. An international database of human and animal ECG signals would be useful in order to evaluate the different algorithms for CPR artifact removal on a common basis.…”

“…• The Norwegian research group of Eftestol, Husoy et al [5], [16], [17] applies an adaptive filtering approach using additional reference signals (thoracic impedance, compression depth, etc. ), which correlate with the CPR artifact signal.…”

“…), which correlate with the CPR artifact signal. Besides the analysis of an SNR improvement, they evaluated the performance of a shock advice algorithm before and after artifact removal [16], [17].…”