(Circulation. 2001;103:2483.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Is Arrhythmia Detection by Automatic External Defibrillator Accurate for Children?
Sensitivity and Specificity of an Automatic External Defibrillator Algorithm in 696 Pediatric Arrhythmias
From the University of Washington (F.C., B.W.D., F.M.L., G.L.R.) and Agilent Technologies (D.B.J., D.S., T.D.L., B.C.), Seattle, Wash; Harvard Medical School (C.I.B.), Boston, Mass; Children’s Hospital and Health Center (J.C.P., A.A.Z.), San Diego, Calif; and the University of Iowa (D.L.A.), Iowa City.
Correspondence to Frank Cecchin, MD, Children’s Hospital and Medical Center, 4800 Sandpoint Way, NE, Seattle, WA 98105. E-mail fcecch{at}chmc.org
Background—Use of automatic external defibrillators (AEDs) in children aged <8 years is not recommended. The purpose of this study was to develop an ECG database of shockable and nonshockable rhythms from a broad age range of pediatric patients and to test the accuracy of the Agilent Heartstream FR2 Patient Analysis System for sensitivity and specificity.
Methods and
Results—Children aged 
12 years who
either developed arrhythmias or were at risk for developing
arrhythmias were studied. Two sources were used for the
database: children whose rhythms were recorded prospectively via a
modified AED and children who had arrhythmias captured on paper
and digitized for subsequent analysis. The rhythms were divided
into 5-second strips, classified by 3 reviewers, and then assessed by
the AED analysis algorithm. A total of 696 five-second rhythm
strips from 191 children (81 female and 110 male) aged 1 day to 12
years (median 3.0 years) were analyzed. There was 100%
specificity for nonshockable rhythms. Sensitivity for
ventricular fibrillation was
96%.
Conclusions—There was excellent AED rhythm analysis sensitivity and specificity in all age groups for ventricular fibrillation and nonshockable rhythms. The high specificity and sensitivity indicate that there is a very low risk of an inappropriate shock and that the AED correctly identifies shockable rhythms, making the algorithm both safe and effective for children.
Key Words: defibrillation • pediatrics • arrhythmia
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