Apparatus and method for determining return of spontaneous circulation

Abstract

Disclosed are an apparatus and a method for determining whether a target heart has returned to spontaneous circulation according to an embodiment. The apparatus for determining whether a target heart has returned to spontaneous circulation according to an embodiment comprises: one or more processors; and one or more memories storing instructions executed by the one or more processors. The one or more processors: determine the opened / closed state of a valve within the target heart on the basis of first bio-signal generated in response to the physical activity of the target heart; and determine whether the target heart has returned to spontaneous circulation on the basis of the opened / closed state of the valve.

Description

Device and method for determining return of spontaneous circulation

[0001] The disclosed embodiments relate to a device and method for determining ROSC without pulse measurement, utilizing biosignals representing electrical and physical activity of the subject's heart.

[0002] [Cross-reference to related applications]

[0003] This application claims priority to Republic of Korea Patent Application No. 10-2024-0065977, filed May 21, 2024, the entire contents of which are incorporated herein by reference.

[0004] Cardiac arrest is a critical public health issue worldwide. Looking at the prognosis of out-of-hospital cardiac arrest, less than 4% of patients are able to return to their normal lives. While ongoing research is being conducted on the survival rates and favorable neurological outcomes of patients with out-of-hospital cardiac arrest, no breakthrough treatment has yet been developed to significantly improve survival or the rate of return to normal life.

[0005] When a cardiac arrest occurs, initial treatment is important. Since rapid treatment of out-of-hospital cardiac arrest must be performed at the scene of the incident, it is very important for witnesses / discoverers and paramedics to perform high-quality CPR.

[0006] High-quality CPR emphasizes appropriate chest compression depth and rate, minimizing interruptions in chest compressions. Appropriate chest compression depth and rate are key elements of basic resuscitation training, and can be acquired through CPR training using manikin devices and continuously refined through periodic training.

[0007] Even if chest compressions are performed at the appropriate depth and rate, their effectiveness declines dramatically if they are not performed consistently. Therefore, the American Heart Association (AHA) Basic Life Support Guidelines recommend measuring the chest compression fraction (CCF), which represents the percentage of total CPR time spent performing chest compressions, and aiming for a CCF of 80% or greater.

[0008] However, during CPR, return of spontaneous circulation (ROSC) must be confirmed every two minutes through electrocardiogram analysis and pulse palpation, which inevitably causes interruption of chest compressions every two minutes. According to the AHA basic life support guidelines, ROSC must be confirmed through electrocardiogram analysis and pulse palpation, and among them, pulses should be checked by palpating the carotid and femoral arteries, and it is recommended that pulse palpation be performed within 10 seconds to minimize interruption of chest compressions.

[0009] However, checking for a pulse can be time-consuming and not very accurate. A study of emergency medical technicians found that 10% failed to recognize a pulse when it was absent, and 45% failed to recognize a pulse when it was present. Furthermore, checking for a pulse took longer than recommended, taking 30 seconds to confirm an absence of a pulse and 15 seconds to confirm a pulse when a pulse was present. This not only significantly deviates from the AHA BLS guidelines, but also significantly impacts patient outcomes by prolonging the pause in chest compressions and lowering the cardiac arrest factor (CCF).

[0010] Checking for a pulse is especially challenging during bystander CPR. Even for experienced emergency medical technicians, palpating a pulse to confirm ROSC in a shaking ambulance is extremely challenging. Even if ROSC is restored, cardiac arrest can recur within minutes, necessitating continuous monitoring and pulse checks. Even in these instances, checking for a pulse at the scene or during transport is challenging. All of these factors ultimately worsen the prognosis of cardiac arrest patients.

[0011] Despite these issues, pulse detection methods have remained unchanged for over 30 years, remain time-consuming, and their accuracy has not improved. To address these issues, we aim to develop an artificial intelligence algorithm that can determine ROSC during CPR using a patch that utilizes ECG and GCG. If ECG rhythm and pulse detection can be performed objectively and quickly during CPR, both laypersons and medical professionals will be able to more easily assess ROSC. Furthermore, rather than simply observing a pulse, which is an indirect indicator of a heartbeat, this method provides direct evidence of meaningful cardiac activity, which is expected to contribute to more accurate assessments of ROSC.

[0012] The disclosed embodiments can determine whether a subject's heart has returned to spontaneous circulation through multivariate analysis of biosignals representing electrical or physical activity of the subject's heart.

[0013] A device for determining ROSC according to one embodiment is a device for determining whether a subject's heart has ROSC, comprising: one or more processors; and one or more memories storing instructions executed by the one or more processors, wherein the one or more processors: determine an open / closed state of a valve in the subject's heart based on a first biosignal generated in response to a physical activity of the subject's heart, and determine whether the subject's heart has ROSC based on the open / closed state of the valve.

[0014] The valve includes a first valve and a second valve, and the one or more processors can: determine whether the first valve of the target heart is open based on the first biosignal, and if the first valve is in an open state, determine whether the return of spontaneous circulation of the target heart is successful.

[0015] The valve includes a first valve and a second valve, and the one or more processors can: determine whether the second valve of the target heart is closed based on the first biosignal, and if the second valve is closed, determine whether the return of spontaneous circulation of the target heart is successful.

[0016] The valve includes a first valve and a second valve, and the one or more processors: determine whether the first valve is open and the second valve is closed during the systole of the target heart based on the first bio-signal, and when the open / closed state of the valve is at least one type among a first type in which the first valve is open and a second type in which the second valve is closed, determine whether the spontaneous circulation of the target heart is successfully restored.

[0017] The above first biosignal may include GCG and / or SCG.

[0018] According to one embodiment, a device for determining whether a subject's heart has recovered spontaneous circulation comprises one or more processors and one or more memories storing instructions executed by the one or more processors, wherein the one or more processors: determine a physical cycle of the subject's heart based on a first biosignal generated in response to physical activity of the subject's heart; determine an electrical cycle of the subject's heart based on a second biosignal generated in response to electrical activity of the subject's heart; determine whether the physical activity and the electrical activity correspond based on the physical cycle and the electrical cycle; and determine whether the subject's heart has recovered spontaneous circulation based on the correspondence.

[0019] The one or more processors may determine whether the target heart has recovered spontaneous circulation as a failure if they determine that the physical cycle and the electrical cycle do not correspond or whether correspondence cannot be determined.

[0020] The one or more processors may determine whether the target heart has successfully recovered spontaneous circulation if they determine that the physical cycle and the electrical cycle correspond.

[0021] According to one embodiment, a device for determining whether a subject's heart has recovered spontaneous circulation comprises one or more processors; and one or more memories storing instructions executed by the one or more processors, wherein the one or more processors: determine an open / closed state of a valve in the subject's heart based on a first biosignal generated in response to a physical activity of the subject's heart; determine an electrical activity state of the subject's heart based on a second biosignal generated in response to an electrical activity of the subject's heart; and determine whether the subject's heart has recovered spontaneous circulation based on the open / closed state of the valve and the electrical activity state.

[0022] The above valve includes a first valve and a second valve, and the one or more processors can: determine the open / closed state of the valve as responsive when the first valve is in an open state and the second valve is in a closed state, and determine other states as non-responsive.

[0023] The one or more processors may further determine whether the first biosignal and the second biosignal correspond to each other or not.

[0024] The one or more processors may determine whether the spontaneous circulation has been restored based on two or more of the electrical activity state, the open / closed state of the valve, and the response.

[0025] The one or more processors may: determine the electrical activity state of the target heart as pVT or an organized rhythm, and, if the open / closed state of the valve is determined to be unresponsive, determine whether the return of spontaneous circulation of the target heart has failed.

[0026] The one or more processors may: determine whether the target heart has recovered spontaneous circulation if the electrical activity state of the target heart is determined to be PEA, pVT, or an organized rhythm, and the open / closed state of the valve is determined to be unresponsive, and determine whether the target heart has recovered spontaneous circulation if the electrical activity state of the target heart is determined to be PEA, pVT, or an organized rhythm, and the open / closed state of the valve is determined to be responsive, and determine whether the target heart has recovered spontaneous circulation if the electrical activity state of the target heart is determined to be PEA, pVT, or an organized rhythm.

[0027] The one or more processors may determine whether the recovery of spontaneous circulation is successful if the open / closed state of the valve of the target heart is responsive and the response is determined as responsive.

[0028] The one or more processors may: determine the electrical activity state of the target heart as pVT, determine the open / closed state of the valve of the target heart as responsive, and determine whether the response is nonresponsive, and determine whether the return of spontaneous circulation is a failure.

[0029] The one or more processors may: determine the electrical activity state of the target heart as an organized rhythm, determine the open / closed state of the valve of the target heart as a response, and determine whether the response is non-responsive, and determine whether the return of spontaneous circulation is a failure.

[0030] The one or more processors may: determine the electrical activity state of the target heart as PEA, V-fib, pVT, or an organized rhythm, determine the open / closed state of the valve of the target heart as a response, and determine whether there is a response, and if so, determine whether the return of spontaneous circulation is successful.

[0031] A method for determining whether a subject's heart has recovered spontaneous circulation according to one embodiment is a method performed on a device for determining whether a subject's heart has recovered spontaneous circulation, the device comprising: one or more processors; and one or more memories storing instructions executed by the one or more processors, the method comprising: a step of determining whether a valve in the subject's heart is open or closed based on a first biosignal generated in response to a physical activity of the subject's heart; and a step of determining whether the subject's heart has recovered spontaneous circulation based on the open or closed state of the valve.

[0032] The method includes: a step of determining an open / closed state of a valve in the target heart based on a first biosignal generated in response to physical activity of the target heart; a step of determining an electrical activity state of the target heart based on a second biosignal generated in response to electrical activity of the target heart; and a step of determining whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve and the electrical activity state.

[0033] A method for determining whether a subject's heart has recovered spontaneous circulation according to one embodiment is a method performed by a device for determining whether a subject's heart has recovered spontaneous circulation, the device comprising: one or more processors; and one or more memories storing instructions executed by the one or more processors, the method comprising: determining whether the subject's heart has recovered spontaneous circulation based on a biosignal including GCG and / or SCG as a first biosignal generated in response to physical activity of the subject's heart.

[0034] In one embodiment, an automated external defibrillator includes a device for determining ROSC of a subject heart as described above; a pad configured to contact a patient including the subject heart; an electrode included in the pad configured to apply an electrical stimulus to the patient; a first sensor for detecting the first biosignal generated in response to physical activity of the subject heart; a second sensor for detecting the second biosignal generated in response to electrical activity of the subject heart; a communication circuit configured to communicate with the device for determining ROSC of the subject heart by wired or wireless connection; and an output device for guiding a compression feedback signal in at least one of a voice, a visual, and a vibration mode based on the ROSC received from the device for determining ROSC of the subject heart.

[0035] A mechanical cardiopulmonary resuscitation device according to one embodiment includes a device for determining the return of spontaneous circulation of the subject heart as described above; a driving device connected to a motor for applying pressure to the subject heart through a reciprocating motion; and a controller for controlling the motor to control the speed of the reciprocating motion, wherein the controller is configured to control the speed depending on whether the device for determining the return of spontaneous circulation of the subject heart has determined that there is a return of spontaneous circulation.

[0036] The disclosed embodiments determine whether the subject's heart has recovered spontaneous circulation by using different bio-signals objectively measured by sensors, thereby omitting pulse measurement, which requires subjective judgment.

[0037] The disclosed embodiments determine whether the subject's heart has recovered spontaneous circulation without measuring the pulse by performing multivariate analysis on variables extracted from different bio-signals, and thus can determine whether the subject has recovered spontaneous circulation while performing chest compressions on the patient.

[0038] FIG. 1 is a block diagram illustrating a device for determining spontaneous circulation recovery according to one embodiment.

[0039] Figure 2 is a diagram illustrating an electrocardiogram showing the asystole state of the target heart.

[0040] Figure 3 is a diagram illustrating an electrocardiogram showing the PEA (Pulseless Electrical Activity) state of the target heart.

[0041] Figure 4 is a diagram illustrating an electrocardiogram showing a V-fib (ventricular fibrillation) state of the target heart.

[0042] Figure 5 is a diagram illustrating an electrocardiogram showing a pulseless ventricular tachycardia (pVT) state of the target heart.

[0043] Figure 6 is a diagram illustrating an electrocardiogram showing the organized rhythm (Organized QRS) of the target heart.

[0044] Figure 7 is a drawing for explaining the open / closed state of the target cardiac valve.

[0045] FIG. 8 is a diagram illustrating a multivariate analysis-based algorithm used by a device for determining spontaneous circulation recovery according to one embodiment.

[0046] Figure 9 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0047] Figure 10 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0048] Figure 11 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0049] FIGS. 12A to 12C are diagrams illustrating hardware of an example of a device for determining whether spontaneous circulation has been restored according to one embodiment.

[0050] FIG. 13 is a drawing for explaining an automated external defibrillator in which a device for determining whether or not spontaneous circulation has been restored is utilized according to one embodiment.

[0051] Hereinafter, specific embodiments of one embodiment will be described with reference to the drawings. The following detailed description is provided to facilitate a comprehensive understanding of the invention described herein. However, this is merely an example and the invention is not limited thereto.

[0052] In describing certain embodiments, detailed descriptions of known technologies related to the present invention will be omitted if they are deemed to unnecessarily obscure the gist of the embodiments. Furthermore, numbers (e.g., "first," "second," etc.) used in the description of the embodiments are merely identifiers used to distinguish one component from another.

[0053] The terms described below are terms defined in consideration of their functions in the present invention, and may vary depending on the intention or custom of the user or operator. Therefore, their definitions should be made based on the contents throughout this specification. The terminology used in the detailed description is only for the purpose of describing one embodiment and should never be limited. Unless clearly used otherwise, the singular form includes the plural form. In this description, expressions such as "comprises" or "having" are intended to indicate certain components, numbers, steps, operations, elements, parts or combinations thereof, and should not be construed to exclude the presence or possibility of one or more other components, numbers, steps, operations, elements, parts or combinations thereof other than those described.

[0054] Furthermore, the embodiments described herein may have aspects that are entirely hardware, partially hardware and partially software, or entirely software. As used herein, the terms "unit," "apparatus," "module," "device," "server," or "system" refer to hardware, a combination of hardware and software, or a computer-related entity such as software. For example, a unit, apparatus, module, device, server, or system may refer to hardware that constitutes part or all of a platform and / or software such as an application for operating the hardware. As a specific example, a unit, apparatus, module, device, server, or system may be implemented by a processor.

[0055] FIG. 1 is a block diagram illustrating a device (100) for determining spontaneous circulation recovery according to one embodiment.

[0056] A device (100) for determining recovery of spontaneous circulation according to one embodiment can determine whether or not the target heart has recovered spontaneous circulation based on the open / closed state of the valve.

[0057] The processor (110) determines the open / closed state of the valve in the target heart based on a first biosignal generated in response to the physical activity of the target heart.

[0058] Here, the first biosignal may include Gyrocardiography (GCG), which records the physical activity of the heart. GCG may refer to a signal representing the contraction and relaxation activity of the heart by utilizing the vibration of the heart through a MEMS gyroscope placed on the chest wall.

[0059] As another example, the first biosignal may include a seismocardiogram (SCG), which records the physical activity of the heart. SCG can be a signal that captures the corresponding cardiovascular system by measuring local vibrations of the chest caused by the heartbeat using an accelerometer.

[0060] As another example, the first biosignal may include photoplethysmography (PPG), which records the physical activity of the heart. PPG may refer to signals that record oxygen saturation and pulse rate when sensors are placed in contact with peripheral parts of the body, including fingers, toes, ears, and forehead.

[0061] Specifically, the processor (110) can determine the open / closed state of the valve of the target heart based on a first bio-signal, such as GCG and / or SCG, and determine whether or not spontaneous circulation has occurred based on the open / closed state of the valve. That is, the processor (110) can determine the open / closed state of the valve of the target heart based on the first bio-signal, and determine whether or not spontaneous circulation has occurred based on the determined open / closed state.

[0062] Specifically, the processor (110) can determine whether the first valve of the target heart is open. The processor (110) can determine whether the second valve of the target heart is closed. At this time, the processor (110) can determine the open / closed state of at least one of the first valve and the second valve during the systole and / or diastole of the target heart.

[0063] Here, the first valve may include the aortic valve, and the second valve may include the mitral valve. In this case, the first valve and the second valve are included in the valve, and the valve is assumed to refer to both the first valve and the second valve.

[0064] Meanwhile, the first and second valves are described as the aortic valve and the mitral valve, respectively, but this is only an example and is not necessarily limited to this. Of course, other valve types, such as the tricuspid valve and the pulmonary valve, can be used as variables.

[0065] The processor (110) determines whether the subject's heart has recovered spontaneous circulation based on the open / closed state of the valve. The processor (110) can also determine whether the subject's heart has recovered spontaneous circulation by classifying the open / closed state of the valve as responsive or unresponsive.

[0066] Specifically, the processor (110) can determine the open / closed state of the valve by a response when the first valve of the target heart is in an open state. The processor (110) can determine the open / closed state of the valve by a response when the second valve of the target heart is in an open state.

[0067] When the processor (110) determines that the valve is at least one of the first type in which the first valve is in an open state during systole of the heart and the second type in which the second valve is in a closed state, the processor can determine that the open / closed state of the valve is responsive, and determine that the other states are unresponsive.

[0068] Here, "responsive" medically refers to the normal functioning of the first and second valves. "Unresponsive" refers to a malfunction of the heart valve. For example, unresponsiveness may include a case where the first valve fails to fully open during systole, preventing blood from flowing through the aorta to the tissues. Alternatively, unresponsiveness may include a case where the second valve fails to fully close during systole, allowing blood to flow back into the left atrium.

[0069] If the processor (110) determines that the first valve of the target heart is open based on the first biosignal, that is, if the open / closed state of the valve is determined as a response, it can determine whether the spontaneous circulation of the target heart has been successfully restored.

[0070] For example, if the processor (110) determines that the second valve of the target heart is closed based on the first bio-signal, that is, if the open / closed state of the valve is determined to be responsive, it can determine whether the spontaneous circulation of the target heart has been successfully restored.

[0071] For example, if the processor (110) determines that the valve is at least one of a first type in which the first valve is in an open state during systole of the target heart and a second type in which the second valve is in a closed state during systole of the target heart, that is, if the open / closed state of the valve is determined to be responsive, it can determine whether the spontaneous circulation of the target heart has been successfully restored.

[0072] On the other hand, the processor (110) can determine whether the spontaneous circulation of the target heart has failed if the first valve is closed and the second valve is open during systole of the target heart, i.e., if the open / closed state of the valves is determined to be unresponsive.

[0073] A device (100) for determining recovery of spontaneous circulation according to one embodiment can determine whether recovery of spontaneous circulation has occurred by determining whether physical activity and electrical activity of the target heart correspond.

[0074] The processor (110) can determine whether the target heart has recovered spontaneous circulation based on whether the physical cycle and electrical cycle of the target heart correspond.

[0075] Here, the processor (110) can determine the physical cycle of the target heart based on the first biosignal generated in response to the physical activity of the target heart. In this case, the physical cycle may refer to the cycle of mechanical activity that repeats contraction and relaxation of the target heart.

[0076] The processor (110) can determine the electrical cycle of the target heart based on a second biosignal generated in response to the electrical activity of the target heart. In this case, the electrical cycle may refer to a cycle of physiological activity that repeats depolarization and repolarization of the target heart.

[0077] The second biosignal may include an ECG (electrocardiogram), which records the electrical activity of the heart. Here, the ECG may refer to a signal that records the interval and intensity of the electrical signals that cause the heart to beat through electrodes attached to the skin.

[0078] If the processor (110) determines that the physical cycle and the electrical cycle do not correspond, or if it is impossible to determine whether they correspond, it may determine that the spontaneous circulation of the target heart has failed. Conversely, if the processor (110) determines that the physical cycle and the electrical cycle correspond, it may determine that the spontaneous circulation of the target heart has succeeded.

[0079] Specifically, the processor (110) can determine that the first biosignal and the second biosignal correspond if their syncs are comprehensively identical, and that they do not correspond if they are not. In this case, the processor (110) can determine whether the first biosignal and the second biosignal correspond by mapping the cardiac cycle and / or the waveform characteristics of the heart.

[0080] A device (100) for determining whether spontaneous circulation has been restored according to one embodiment may determine whether spontaneous circulation has been restored in a target heart using a first biosignal and a second biosignal.

[0081] For example, a device (100) for determining whether spontaneous circulation has been restored can determine whether spontaneous circulation has been restored in a target heart based on the electrical activity status of the target heart and the opening / closing status of the valve.

[0082] First, the processor (110) can determine whether the valve is open or closed in a responsive or non-responsive state based on the first biosignal.

[0083] Thereafter, the processor (110) can determine the electrical activity state of the target heart based on the second biosignal.

[0084] At this time, the processor (110) can determine the electrical activity state that the target heart can have as one of asystole, PEA (Pulseless Electric Activity), V-fib (Ventricular fibrillation), pVT (Pulseless Ventricular Tachycardia), or organized QRS.

[0085] Here, the processor (110) can classify the electrical activity state of the target heart by considering at least one of the heart rate detected in the second biosignal, the presence or absence of the QRS complex, the regularity of the rhythm, the presence or absence of the P wave, the waveform shape of one cycle, and the waveform shape of all cycles.

[0086] Thereafter, the processor (110) determines the electrical activity state of the target heart as PEA, pVT, or organized rhythm, and if the open / closed state of the valve is determined to be unresponsive, it can determine whether the spontaneous circulation of the target heart has failed.

[0087] As another example, if the processor (110) determines that the electrical activity state of the target heart is PEA, pVT, or an organized rhythm and that the valve's open / closed state is responsive, it can determine whether the target heart's recovery of spontaneous circulation is successful.

[0088] A device (100) for determining whether spontaneous circulation has been restored according to one embodiment may determine whether spontaneous circulation has been restored in a target heart based on the open / closed state of a valve and the correspondence between a first biosignal and a second biosignal.

[0089] Specifically, the processor (110) can determine whether the recovery of spontaneous circulation is successful if the open / closed state of the valve of the target heart is responsive and the response is determined as responsive.

[0090] A device (100) for determining whether or not a patient has recovered spontaneous circulation according to one embodiment can determine whether or not a patient has recovered spontaneous circulation based on the electrical activity of the patient's heart, the open / closed state of its valves, and the correspondence between a first biosignal and a second biosignal. A specific embodiment will be described later with reference to FIG. 8.

[0091] The memory (120) stores instructions executed by the processor (110).

[0092] The memory (120) may include at least one type of storage medium among a flash memory type, a hard disk type, an SSD type, an SDD type, a multimedia card micro type, a card type memory (e.g., SD or XD memory, etc.), a random access memory (RAM), a static random access memory (SRAM), a read-only memory (ROM), an electrically erasable programmable read-only memory (EEPROM), a programmable read-only memory (PROM), a magnetic memory, a magnetic disk, and an optical disk. In addition, the memory (120) may be a database that is separate from the device but is connected by wire or wirelessly.

[0093] Meanwhile, it is preferable that the first biosignal and the second biosignal are preprocessed to remove noise or extract useful information using a Fourier transform, a wavelet transform, a band-pass filter, and / or a noise-removing auto-encoder.

[0094] Here, the first biosignal and the second biosignal are described as being, by way of example, one of ECG, GCG, SCG, and PPG, but any data that records electrical and physical signals of the heart may be included therein, and is not necessarily limited to the examples described above.

[0095] Meanwhile, the device (100) for determining ROSC according to one embodiment may be implemented in conjunction with various medical devices (e.g., mechanical automated cardiopulmonary resuscitation device, automated external defibrillator (AED)), industrial or home robots, and unmanned transport devices (e.g., drones). For example, the device (100) for determining ROSC may be linked to a mechanical cardiopulmonary resuscitation device and cause the mechanical cardiopulmonary resuscitation device to stop or continue performing cardiopulmonary resuscitation.

[0096] A mechanical cardiopulmonary resuscitation device is an emergency medical device that is attached to the chest of a cardiac arrest patient and mechanically performs chest compressions at a certain depth and speed. At this time, the mechanical cardiopulmonary resuscitation device may be implemented to be combined with a device (100) that determines whether or not ROSC has occurred, and if the device (100) that determines whether or not ROSC has occurred successfully based on the above-described algorithm, defibrillation and / or chest compression may be stopped, and if ROSC has failed, defibrillation and / or chest compression may be continued.

[0097] From this, the device (100) for determining the return of spontaneous circulation can be linked to an unmanned or semi-automatic structure system to automatically stop the operation of unnecessary chest compression or electric shock, or provide a trigger signal to switch the operation mode, thereby compensating for the imperfections of the unmanned or semi-automatic structure, and can be linked to a means of transportation to improve treatment accessibility.

[0098] Figure 2 is a diagram illustrating an electrocardiogram showing the asystole state of the target heart.

[0099] Asystole is a condition in which the heart is in a state of quiescence, with no physical activity or discernible electrical activity, as shown in Figure 2. Asystole lacks the normal waves that represent ventricular depolarization and repolarization, instead appearing as a flat line, indicating the absence of electrical activity.

[0100] Figure 3 is a diagram illustrating an electrocardiogram showing the PEA (Pulseless Electrical Activity) state of the target heart.

[0101] PEA is a condition in which electrical activity of the heart is observed on an electrocardiogram (ECG), but no pulse is palpable. In other words, PEA is a condition in which the heart's electrical activity is present but its physical activity for blood circulation is lacking. In PEA, the heart is physically contracting, with actual electrical signals, but no pulse is detected.

[0102] Figure 4 is a diagram illustrating an electrocardiogram showing a V-fib (ventricular fibrillation) state of the target heart.

[0103] Ventricular fibrillation (V-Fib) is characterized by rapid, chaotic electrical activity in the ventricles. On the electrocardiogram (ECG), V-Fib has a completely irregular rhythm, with no discernible P waves or QRS complexes. The PR and RR intervals are also indistinguishable. Physically, V-Fib is considered to be a ventricular fibrillation rather than a contraction of the heart.

[0104] Figure 5 is a diagram illustrating an electrocardiogram showing a pulseless ventricular tachycardia (pVT) state of the target heart.

[0105] PVT is characterized by rapid, chaotic electrical activity in the ventricles. Unlike V-fib, it has a lower heart rate and a generally regular, but occasionally irregular, rhythm. PVT is characterized by a prolonged QRS complex of 0.12 seconds or more. In pVT, the heart contracts insufficiently to supply blood to the body's organs and tissues.

[0106] Figure 6 is a diagram illustrating an electrocardiogram showing the organized rhythm (Organized QRS) of the target heart.

[0107] An organized rhythm is defined as a pattern in which the P wave, representing atrium depolarization, is followed by the QRS complex, representing ventricular depolarization. In this pattern, the heart's physical activity synchronizes with its electrical activity, ensuring blood supply to the body and tissues.

[0108] An organized rhythm can mean a condition in which the heartbeat is regular and the heart rate is within the medically defined normal range.

[0109] For example, if the heartbeat rate is faster or slower than what is medically defined as a normal heartbeat rhythm, the heartbeat may be classified as having a disorganized rhythm. Alternatively, if the heart rate is less than 60 beats per minute or greater than 100 beats per minute, it may be classified as deviant from a structured rhythm. In this case, the normal heart rate for an adult at rest is assumed to be between 60 and 100 beats per minute. However, heartbeat rates are merely examples and are not necessarily limited to the aforementioned categories.

[0110] Figure 7 is a drawing for explaining the open / closed state of the target cardiac valve.

[0111] FIG. 7 illustrates, by way of example, an aortic valve (710) as a first valve (710) and a mitral valve (720) as a second valve (720).

[0112] The aortic valve (710) is located between the ventricle and the aorta. When the left ventricle contracts, the pressure within the ventricle increases, causing the aortic valve (710) to open. When the aortic valve (710) opens, blood is ejected from the left ventricle into the aorta, thereby distributing blood to the extremities. When the left ventricle relaxes, the pressure within the ventricle decreases, and this decrease in pressure closes the aortic valve (710). Closure of the aortic valve (710) prevents blood from flowing backward into the left ventricle during ventricular diastole. This maintains the forward flow of blood. Conversely, if the aortic valve (710) does not open properly during left ventricular diastole, blood may not be distributed smoothly. In this case, the mechanism of the aortic valve (710) is considered abnormal.

[0113] The mitral valve (720) is located in the left atrium and the left ventricle. When the left atrium contracts, the pressure within the atrium increases, causing the mitral valve (720) to open. At this time, when the mitral valve (720) opens, blood flows from the left atrium to the left ventricle. When the left ventricle fills with blood, the left ventricle contracts. The contraction of the left ventricle causes the pressure within the ventricle to increase, causing the mitral valve (720) to close. As the mitral valve (720) closes, the backflow of blood from the left ventricle to the left atrium is prevented, enabling effective blood supply. On the other hand, if the mitral valve (720) does not close properly during left ventricular systole, backflow of blood may occur. In this case, the mechanism of the mitral valve (720) is determined to be abnormal.

[0114] Here, the cases of being closed and not open may refer to cases where the opening and closing is completely or partially closed or not open, and may include cases where it is almost closed, almost not closed, almost open, or almost not open. Furthermore, the cases of being closed and not open may of course include cases where it is not opened and closed when it should be opened and closed according to the normal mechanism, and then the opening and closing is performed belatedly.

[0115] That is, the processor (110) can utilize at least one of whether the aortic valve (710) is open and whether the mitral valve (720) is closed during systole of the heart as an independent variable for determining return of spontaneous circulation, as a type of abnormal valve mechanism.

[0116] FIG. 8 is a diagram for explaining a multivariate analysis-based algorithm used by a device (100) for determining spontaneous circulation recovery according to one embodiment.

[0117] Referring to FIG. 8, the processor (110) determines whether the target heart has recovered spontaneous circulation by using the ECG as a second biosignal and the GCG and / or SCG as a first biosignal.

[0118] The processor (110) determines the electrical activity state of the target heart based on the ECG. Here, the processor (110) can classify the electrical activity state of the target heart as any one of asystole, PEA, V-fib, pVT, or organized rhythm.

[0119] The processor (110) can determine the open / closed state of the target heart valve based on the GCG or SCG. Here, the processor (110) can determine whether the mitral valve is closed and the aortic valve is open during systole of the target heart. In other words, the processor (110) can determine whether multiple valves that open / close during systole of the target heart are functioning normally.

[0120] The processor (110) can determine whether the ECG signal and the GCG signal or the ECG signal and the SCG signal correspond to each other. That is, the processor (110) can determine whether the ECG signal and the GCG signal or the ECG signal and the SCG signal are synchronized.

[0121] The processor (110) can ultimately determine whether the target heart has recovered spontaneous circulation by performing multivariate analysis using as variables the electrical activity status of the target heart, whether the valves function normally, and whether the electrical activity and physical activity of the target heart correspond.

[0122] For example, if the processor (110) determines that the electrical activity state of the target heart is asystole, the processor (110) can determine whether or not the return of spontaneous circulation has occurred as a failure, regardless of whether or not the open / closed state of the valves of the target heart corresponds to the open / closed state.

[0123] Meanwhile, in the second column of Fig. 8, which represents the second independent variable, O and X represent response and non-response, respectively. In the third column of Fig. 8, which represents the third independent variable, O and X represent correspondence and non-correspondence between the first and second biosignals, respectively. Meanwhile, N / A represents a case where it is not observed or cannot be observed. In the fourth column of Fig. 8, which represents the last dependent variable, O and X represent success and failure of ROSC, respectively.

[0124] As another example, when the processor (110) determines the electrical activity state of the target heart as PEA and determines whether it responds or not, the processor (110) can determine whether the return of spontaneous circulation is successful or not, regardless of the open / closed state of the valve.

[0125] As another example, even if the processor (110) determines the electrical activity state of the target heart as V-fib and cannot determine whether there is a response, the processor (110) can determine whether the return of spontaneous circulation is a failure regardless of the open / closed state of the valve of the target heart.

[0126] For example, if the processor (110) determines the electrical activity state of the target heart as pVT and determines the open / closed state of the target heart valve as non-responsive, the processor (110) can determine whether or not ROSC has occurred as a failure, regardless of whether or not there is a response. In other words, the processor (110) can determine whether or not ROSC has occurred as a failure even if it cannot determine whether or not there is a response.

[0127] As another example, when the processor (110) determines the electrical activity state of the target heart as pVT, determines the open / closed state of the valve of the target heart as responsive, and determines whether there is a response or not as non-responsive, the processor (110) can determine whether there is a return of spontaneous circulation as a failure.

[0128] As another example, if the processor (110) determines the electrical activity state of the target heart as an organized rhythm and determines the open / closed state of the target heart valve as non-responsive, the processor (110) can determine whether or not ROSC has failed regardless of whether or not there is a response. In other words, even if the processor (110) cannot determine whether or not there is a response, it can determine whether or not there is a ROSC has failed under the same conditions.

[0129] As another example, when the processor (110) determines the electrical activity state of the target heart as an organized rhythm, determines the open / closed state of the valve of the target heart as a response, and determines whether there is a response as a non-response, the processor (110) can determine whether there is a return of spontaneous circulation as a failure.

[0130] On the other hand, if the processor (110) determines that the electrical activity state of the target heart is not asystole, that is, determines the electrical activity state of the target heart as PEA, V-fib, pVT, or organized rhythm, determines the open / closed state of the valve of the target heart as a response, and determines whether there is a response as a response, the processor (110) can determine whether the return of spontaneous circulation is successful.

[0131] Meanwhile, in Fig. 8, a multivariate analysis-based algorithm for determining whether or not there is recovery of spontaneous circulation using ECG and GCG is described, but this is an example, and it is understood that multivariate analysis can be performed using a combination of ECG and SCG or a combination of ECG and PPG.

[0132] Figure 9 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0133] The method of FIG. 9 can be performed by the device (100) for determining spontaneous circulation recovery of FIG. 1.

[0134] A device (100) for determining recovery of spontaneous circulation determines (910) the open / closed state of a valve in a target heart based on a first biosignal generated in response to physical activity of the target heart.

[0135] Thereafter, the device (100) for determining the recovery of spontaneous circulation determines whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve (920).

[0136] Figure 10 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0137] The method of FIG. 10 can be performed by the device (100) for determining spontaneous circulation recovery of FIG. 1.

[0138] A device (100) for determining recovery of spontaneous circulation determines (1010) whether the target heart has recovered spontaneous circulation based on GCG and / or SCG, which are first biosignals generated in response to physical activity of the target heart.

[0139] Figure 11 is a flowchart illustrating a method for determining whether spontaneous circulation has been restored according to one embodiment.

[0140] The method of FIG. 11 can be performed by the device (100) for determining spontaneous circulation recovery of FIG. 1.

[0141] First, the device (100) for determining the return of spontaneous circulation determines the open / closed state of the valve in the target heart based on the first biosignal generated in response to the physical activity of the target heart (1110).

[0142] Thereafter, the device (100) for determining the return of spontaneous circulation determines the electrical activity state of the target heart based on the second biosignal generated in response to the electrical activity of the target heart (1120).

[0143] Thereafter, the device (100) for determining the recovery of spontaneous circulation determines whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve and the electrical activity state (1130).

[0144] The above-described drawings 9 to 11 have been described with reference to the order presented in the drawings. For the purpose of explanation, the method is depicted and described as a series of blocks; however, the present invention is not limited to the order of the blocks, and some blocks may occur in a different order or simultaneously with other blocks than depicted and described herein, and various other branches, flow paths, and block orders that achieve the same or similar results may be implemented. Furthermore, not all of the blocks depicted may be required to implement the method described herein. For example, when one or two or more of ECG, GCG, SCG, and PPG are applied in combination, the blocks may be configured accordingly.

[0145] FIGS. 12A to 12C are drawings for explaining hardware of an example of a device (100) for determining whether spontaneous circulation has been restored according to one embodiment.

[0146] FIG. 12a is a plan view illustrating a device (100) for determining whether spontaneous circulation has been restored according to one embodiment.

[0147] The housing of the device (100) for determining whether or not spontaneous circulation has been restored according to one embodiment may be formed in an oval shape, and may have a smooth curved structure with rounded corners and sides for a comfortable fit and stability when holding the device (100) for determining whether or not spontaneous circulation has been restored when used for chest compressions or cardiopulmonary resuscitation, and may be configured to be of a size that can be wrapped around with one hand.

[0148] The upper surface of the device (100) for determining whether or not ROSC has been achieved according to one embodiment may be provided with instructions for performing chest compressions or cardiopulmonary resuscitation. For example, the upper surface may include instructions for guiding the location of chest compressions (e.g., “Attach the device to the center of the chest”, “Place your hand on the yellow center surface and apply compressions”), so that the user can intuitively recognize the location of compression and take action.

[0149] FIG. 12b is a perspective view illustrating a device (100) for determining whether spontaneous circulation has been restored according to one embodiment.

[0150] A device (100) for determining ROSC according to one embodiment may include one or more indicators on the side of the device to indicate whether chest compressions or CPR being performed are appropriate. For example, the indicators may visually distinguish and output the compression depth (e.g., shallow / appropriate / deep), compression rate (e.g., slow / appropriate / fast), and / or heart condition (e.g., beating / stopped) of the chest compressions.

[0151] In particular, the indicator indicating the heart condition can be illuminated with different colors depending on whether ROSC has occurred, thereby conveying the patient's condition to the user in real time. For example, the indicator can light a green LED if ROSC is determined to be successful, and a red LED if ROSC has failed. Accordingly, the device (100) for determining ROSC according to one embodiment can guide the user to self-correct the quality of chest compressions or cardiopulmonary resuscitation (CPR) through the indicator.

[0152] FIG. 12c is a bottom view illustrating a device (100) for determining whether spontaneous circulation has been restored according to one embodiment.

[0153] A device (100) for determining whether or not spontaneous circulation has been restored according to one embodiment may be provided with a gel-type adhesive pad. In this case, the pad may be configured as a gel-type adhesive pad so that it can be stably attached to a target area (e.g., the chest) of a patient. When in contact with the patient's skin, the adhesive pad flexibly adheres to the curved surface of the chest, preventing displacement during compression and maintaining stable sensor contact.

[0154] Additionally, the pad may include a sensor (e.g., a gyroscope) that detects at least one of compression depth, compression rate, or electrocardiogram signals, and electrodes that detect electrical signals from the target heart. In this case, the pad can minimize signal distortion caused by displacement of the compression position or poor contact during use.

[0155] FIG. 13 is a drawing for explaining an automated external defibrillator (1300) in which a device (100) for determining whether or not spontaneous circulation has been restored according to one embodiment is utilized.

[0156] An automated external defibrillator (1300) according to one embodiment is an automated external defibrillator (1300) capable of real-time compression feedback, and may include a pad (1301), an electrode (not shown), a first sensor (1302), a second sensor (1302), a device (100) for determining the recovery of spontaneous circulation of the target heart as described above, a communication circuit (1304), and an output device (not shown).

[0157] The automated external defibrillator (1300) contacts a patient including a target heart through a pad (1301) and applies electrical stimulation to the patient through an electrode (not shown) included in the pad (1301) so that the target heart can recover a normal rhythm.

[0158] The automated external defibrillator (1300) can obtain a first biosignal (e.g., GCG) generated in response to the physical activity of the target heart using a first sensor (e.g., GCG sensor) included in the pad. The automated external defibrillator (1300) can obtain a second biosignal (e.g., ECG signal) generated in response to the electrical activity of the target heart using a second sensor (e.g., ECG electrode) included in the pad.

[0159] At this time, the device (100) for determining the recovery of spontaneous circulation of the target heart can determine whether the target heart has recovered spontaneous circulation based on the first biosignal and the second biosignal received from the first sensor and the second sensor, respectively.

[0160] Meanwhile, a device (100) for determining the recovery of spontaneous circulation of a target heart is implemented with a microcontroller (1310) in which the corresponding algorithm is implemented, and an automated external defibrillator (1300) is equipped with the corresponding microcontroller (1310) and can be implemented in a form including a device (100) for determining the recovery of spontaneous circulation of a target heart.

[0161] Meanwhile, the GCG signal and the ECG signal can be transmitted to the microcontroller (1310) after the collected signals are preprocessed by amplifying, filtering, and converting the biosignals through the GCG block (1312) and the ECG AFE (1313), respectively.

[0162] The automated external defibrillator (1300) can guide the feedback by providing a compression feedback signal in at least one of voice, visual, and vibration mode through an output device (not shown) based on whether or not spontaneous circulation has been recovered from a device (100) that determines the spontaneous circulation of the target heart.

[0163] For example, an output device (not shown) may output a voice signal such as “Stop compression” or “Continue compression” based on whether or not there is a return of spontaneous circulation, thereby guiding the user on whether or not there is a need to continue the electric shock through the AED.

[0164] At this time, the output device (not shown) can wirelessly receive the processing result of the microcontroller (1310) through a communication circuit (1304), for example, a BLE module.

[0165] Meanwhile, although the first sensor (1303) and the second sensor (1304) have been described as part of the automated external defibrillator (1300), this is merely an example, and may be included in the device (100) for determining return of spontaneous circulation or an external system, and is not necessarily limited to the example. Meanwhile, an embodiment of the present invention may include a program for performing the methods described herein on a computer, and a computer-readable recording medium including the program. The computer-readable recording medium may include program commands, local data files, local data structures, etc., either singly or in combination. The medium may be specially designed and configured for the present invention, or may be commonly used in the field of computer software. Examples of the computer-readable recording medium include magnetic media such as hard disks, floppy disks, and magnetic tapes, optical recording media such as CD-ROMs and DVDs, and hardware devices specially configured to store and execute program commands such as ROMs, RAMs, and flash memories. Examples of the above programs may include not only machine language codes such as those produced by a compiler, but also high-level language codes that can be executed by a computer using an interpreter or the like.

[0166] While representative embodiments of the present invention have been described in detail above, those skilled in the art will appreciate that various modifications to the above-described embodiments are possible without departing from the scope of the present invention. Therefore, the scope of the present invention should not be limited to the described embodiments, but should be determined not only by the claims set forth below but also by equivalents thereof.

[0167] A device for determining the return of spontaneous circulation according to one embodiment determines whether the target heart has returned to spontaneous circulation without measuring the pulse by performing multivariate analysis on variables extracted from different bio-signals, and can be used in the medical device and digital medical industries.

Claims

1. One or more processors; and A device for determining whether a target heart has recovered spontaneous circulation, the device having one or more memories storing instructions executed by one or more processors, One or more of the above processors: Determine the open / closed state of the valve in the target heart based on the first biosignal generated in response to the physical activity of the target heart, A device for determining whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve.

2. In paragraph 1, The above valve includes a first valve and a second valve, One or more of the above processors: Based on the first biosignal, it is determined whether the first valve of the target heart is open, A device for determining whether the spontaneous circulation of the target heart has been successfully restored, when the first valve is in an open state.

3. In paragraph 1, The above valve includes a first valve and a second valve, One or more of the above processors: Based on the first biosignal, it is determined whether the second valve of the target heart is closed, A device for determining whether the spontaneous circulation of the target heart has been successfully restored when the second valve is closed.

4. In paragraph 1, The above valve includes a first valve and a second valve, One or more of the above processors: Based on the first biosignal, determine whether the first valve is open and the second valve is closed during the systole of the target heart, A device for determining whether the spontaneous circulation of the target heart has been successfully restored, wherein the open / closed state of the valve is at least one of a first type in which the first valve is open during systole and a second type in which the second valve is closed during systole.

5. In paragraph 1, A device for determining the return of spontaneous circulation of a target heart, wherein the first biosignal includes GCG and / or SCG.

6. One or more processors; and A device for determining whether a target heart has recovered spontaneous circulation, the device having one or more memories storing instructions executed by one or more processors, One or more of the above processors: Determine the physical cycle of the target heart based on a first biosignal generated in response to the physical activity of the target heart, Determine the electrical cycle of the target heart based on a second biosignal generated in response to the electrical activity of the target heart, Based on the above physical cycle and the above electrical cycle, determine whether the physical activity and the electrical activity correspond, A device for determining whether spontaneous circulation of the target heart has been restored, which determines whether spontaneous circulation of the target heart has been restored based on the above response.

7. In paragraph 6, One or more of the above processors: A device for determining whether or not the spontaneous circulation of the target heart has recovered, which determines whether or not the spontaneous circulation of the target heart has recovered as a failure if it is determined that the above physical cycle and electrical cycle do not correspond or whether or not correspondence cannot be determined.

8. In paragraph 6, One or more of the above processors: A device for determining whether the spontaneous circulation of the target heart has been restored, which determines whether the spontaneous circulation of the target heart has been restored as successful if it is determined that the above physical cycle and electrical cycle correspond.

9. One or more processors; and A device for determining whether a target heart has recovered spontaneous circulation, the device having one or more memories storing instructions executed by one or more processors, One or more of the above processors: Determine the open / closed state of the valve in the target heart based on the first biosignal generated in response to the physical activity of the target heart, Determine the electrical activity state of the target heart based on a second biosignal generated in response to the electrical activity of the target heart, A device for determining whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve and the electrical activity state.

10. In paragraph 9, The above valve includes a first valve and a second valve, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, which determines the open / closed state of the valve as responsive when the first valve is open and the second valve is closed, and determines any other state as unresponsive.

11. In paragraph 10, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, which further determines whether the first biosignal and the second biosignal correspond to each other and whether they correspond.

12. In paragraph 11, One or more of the above processors: A device for determining whether the heart has recovered spontaneous circulation, the device determining whether the heart has recovered spontaneous circulation based on two or more of the electrical activity state, the open / closed state of the valve, and the response state.

13. In paragraph 12, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, which determines the electrical activity state of the target heart as pVT or an organized rhythm, and determines whether the recovery of spontaneous circulation of the target heart has failed if the open / closed state of the valve is determined to be unresponsive.

14. In paragraph 12, One or more of the above processors: If the electrical activity state of the target heart is determined as PEA, pVT, or organized rhythm, and the open / closed state of the valve is determined as unresponsive, the return of spontaneous circulation of the target heart is determined as failed. A device for determining the recovery of spontaneous circulation of a target heart, which determines whether the recovery of spontaneous circulation of the target heart is successful when the electrical activity state of the target heart is determined as PEA, pVT, or an organized rhythm, and the open / closed state of the valve is determined as a response.

15. In paragraph 11, One or more of the above processors: A device for determining whether the spontaneous circulation of the target heart has been restored, wherein the open / closed state of the valve of the target heart is responsive and the response is determined as a response, and the spontaneous circulation has been restored as a success.

16. In paragraph 11, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, wherein the electrical activity state of the target heart is determined as pVT, the open / closed state of the valve of the target heart is determined as a response, and when the response is determined as a non-response, the recovery of spontaneous circulation is determined as a failure.

17. In paragraph 11, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, which determines the electrical activity state of the target heart as an organized rhythm, determines the open / close state of the valve of the target heart as a response, and determines whether the response is non-responsive if the response is determined as a failure.

18. In paragraph 11, One or more of the above processors: A device for determining the recovery of spontaneous circulation of a target heart, which determines the electrical activity state of the target heart as PEA, V-Fib, pVT or organized rhythm, determines the open / close state of the valve of the target heart as a response, and determines whether the response is a response, and determines whether the recovery of spontaneous circulation is successful.

19. One or more processors; and A method performed on a device for determining whether a target heart has returned to spontaneous circulation, the device having one or more memories storing instructions executed by one or more processors, The above method is: A step of determining the open / closed state of a valve in the target heart based on a first biosignal generated in response to physical activity of the target heart; and A method for determining whether the target heart has recovered spontaneous circulation, comprising a step of determining whether the target heart has recovered spontaneous circulation based on the open / closed state of the valve.

20. In paragraph 19, The above method is: A step of determining the open / closed state of a valve in the target heart based on a first biosignal generated in response to physical activity of the target heart; A step of determining the electrical activity state of the target heart based on a second biosignal generated in response to the electrical activity of the target heart; and A method for determining whether the subject's heart has recovered spontaneous circulation, further comprising a step of determining whether the subject's heart has recovered spontaneous circulation based on the open / closed state of the valve and the electrical activity state.

21. One or more processors; and A method performed by a device for determining whether a target heart has returned to spontaneous circulation, the device having one or more memories storing instructions executed by one or more processors, A method for determining whether the target heart has recovered spontaneous circulation, comprising a step of determining whether the target heart has recovered spontaneous circulation based on a biosignal including GCG and / or SCG as a first biosignal generated in response to physical activity of the target heart.

22. An automated external defibrillator capable of real-time compression feedback, including a device for determining the return of spontaneous circulation of the target heart according to Article 6, The above automated external defibrillator: A pad configured to come into contact with a patient including the target heart; An electrode included in the pad and configured to apply electrical stimulation to the patient; A first sensor that detects the first biosignal generated in response to the physical activity of the target heart; A second sensor that detects the second biosignal generated in response to the electrical activity of the target heart; - The device for determining the recovery of spontaneous circulation of the target heart: determines whether the spontaneous circulation has been recovered based on the first bio-signal and the second bio-signal received from each of the first sensor and the second sensor. A communication circuit configured to communicate with a device for determining the recovery of spontaneous circulation of the target heart, either wired or wirelessly; and An automated external defibrillator capable of real-time compression feedback, comprising an output device that guides a compression feedback signal in at least one of audible, visual, and vibrational manner based on whether the target heart has recovered spontaneous circulation, as received from a device that determines whether the target heart has recovered spontaneous circulation.

23. A mechanical cardiopulmonary resuscitation device including a device for determining the return of spontaneous circulation of the target heart according to Article 6, The above mechanical cardiopulmonary resuscitation device: A driving device connected to a motor and applying pressure to the target heart through reciprocating motion; and Including a controller that controls the speed of the reciprocating motion by controlling the motor, A mechanical cardiopulmonary resuscitation device, wherein the controller is configured to control the speed based on whether the spontaneous circulation of the target heart has been recovered as determined by the device for determining the spontaneous circulation of the target heart.

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