AED Shock Advisory Reliability via Clean ECG Segmentation
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Solution Overview
Problem
Current automated external defibrillators (AEDs) face challenges in accurately analyzing cardiac rhythms during cardio-pulmonary resuscitation (CPR due to electrical artifacts from chest compressions, leading to unreliable shock advisories and inability to detect refibrillation, which can result in delayed or inappropriate treatment.
Innovation Solution
A method and system that analyze clean segments of the ECG waveform during CPR to provide a reliability score for shock advisories, using time-sequential ECG and CPR reference signal data sets to classify rhythms as 'shock' or 'no-shock' and adjust the reliability score based on elapsed time since the last hands-off interval, thereby enhancing the accuracy of shock decisions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If CPR is performed continuously without interruption to maintain circulation, then circulation is maintained, but the ability to accurately detect cardiac rhythm and deliver timely shock is compromised due to electrical artifacts from chest compressions
Solution Approach 1:
The patent segments the ECG analysis into clean segments (free from CPR artifacts) and contaminated segments. The system identifies and analyzes only the clean segments to determine shockability, separating the analysis process from the continuous CPR compression artifacts. This allows accurate rhythm detection without interrupting CPR.
Solution Approach 2:
The system performs preliminary identification and classification of clean ECG segments during ongoing CPR before making shock decisions. By pre-identifying usable segments and maintaining a buffer of clean data, the system prepares the necessary information in advance, enabling rapid shock delivery when indicated without delaying for artifact-free periods.
2Productivity
If the interval between CPR compressions and defibrillation shock is shortened to improve shock success, then shock effectiveness increases, but the accuracy of rhythm analysis during CPR may be compromised
Solution Approach 1:
The patent divides the ECG signal into segments based on the presence or absence of CPR artifacts. Clean segments are identified and separated from contaminated segments, allowing accurate rhythm analysis to be performed on only the usable portions of the signal. This segmentation enables precise measurement despite continuous CPR.
Solution Approach 2:
The system uses clean ECG segments as an intermediary medium to accurately assess cardiac rhythm during CPR. Instead of attempting to analyze the entire continuous signal including artifacts, the system relies on these intermediary clean segments to provide accurate rhythm information, enabling precise measurement without stopping CPR.
3Ease of operation
If CPR is interrupted early to deliver a shock for suspected refibrillation, then treatment responsiveness may improve, but the risk of incorrect shock delivery increases due to unreliable rhythm determination
Solution Approach 1:
The system provides feedback by analyzing clean ECG segments during CPR to determine the presence of shockable rhythms. This continuous feedback mechanism allows the system to monitor for refibrillation events and provide accurate shock advisories, enabling operators to respond appropriately to rhythm changes without making incorrect shock decisions based on artifact-contaminated signals.
Data Source
AI summary
A method, system and device to detect and use clean ECG segments, which do not need filtering to remove artifact or CPR-induced noise, is described to provide a reliability score for the decision made by shock advisory algorithms. The method can be implemented in a system and/or device that is provided with a display for indicating to a user the relative quality of the determination of an electrotherapy analysis circuit.