Ventricular fibrillation masquerading as ventricular standstill

Ewy, Gordon A.; Dahl, Charles F.; Zimmerman, Mary; Otto, Charles W.

doi:10.1097/00003246-198105000-00020

Cited by 23 publications

(1 citation statement)

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“…The electrocardiogram (ECG) during VF was, until recently, considered to represent unstructured cardiac electrical activity variously described as random, noisy and chaotic. Techniques used to analyse the VF waveform include amplitude which has not proved to be a reproducible marker of defibrillation success [8,9], Fourier-based spectral analysis [10,11] and techniques from non-linear dynamics such as fractal [12] and phase delay [13] which in practice can often be shown to be related to previously investigated methods [14].…”

Section: Introductionmentioning

confidence: 99%

Wavelet transform-based prediction of the likelihood of successful defibrillation for patients exhibiting ventricular fibrillation

Watson¹,

Addison²,

Clegg

et al. 2005

Meas. Sci. Technol.

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We report on an improved method for the prediction of the outcome from electric shock therapy for patients in ventricular fibrillation: the primary arrhythmia associated with sudden cardiac death. Our wavelet transform-based marker, COP (cardioversion outcome prediction), is compared to three other well-documented shock outcome predictors: median frequency (MF) of fibrillation, spectral energy (SE) and AMSA (amplitude spectrum analysis). Optimum specificities for sensitivities around 95% for the four reported methods are 63 ± 4% at 97 ± 2% (COP), 42 ± 15% at 90 ± 7% (MF), 12 ± 3% at 94 ± 5% (SE) and 56 ± 5% at 94 ± 5% (AMSA), with successful defibrillation defined as the rapid (<60 s) return of sustained (>30 s) spontaneous circulation. This marked increase in performance by COP at specificity values around 95%, required for implementation of the technique in practice, is achieved by its enhanced ability to partition pertinent information in the time–frequency plane. COP therefore provides an optimal index for the identification of patients for whom shocking would be futile and for whom an alternative therapy should be considered.

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