Abstract 15: Electrocardiographic Characteristics for Automated External Defibrillator Algorithms are Different between Children and Adults
Introduction An AED is recommended for children < 8 years if the rhythm detection algorithm has been validated in children with extensive testing. The purpose of our study was to determine if there were significant differences among ECG characteristics between pediatric vs. adult patients.
Methods Digitized recordings of NSR were obtained from PhysioNet’s archives and the ZOLL pediatric database. Rhythms were divided into 9-sec strips, creating 820 samples from; 103 patients < 10 years (children) and 71 patients > 18 years (adult). Rate, QRS signal amplitude, (SA) and conduction (COND) were analyzed. The rate and SA were determined using R-R interval detection and baseline to peak QRS measurements, respectively. COND was defined as the maximum QRS complex slope following the first major deflection, representing the rate of ventricular activation.
Results There were statistical differences between pediatric and adult rhythm characteristics of rate, SA, and COND. (Fig 1⇓) Heart rate for children was significantly higher than adult (113 ± 25 bpm vs 80 ± 16 bpm, P<0.001). Conversely, SA for pediatric subjects was significantly lower than adult subjects (1.2 ± 0.6 mV vs 2.2 ± 0.8 mV, P<0.001), as was COND (35.2 ± 18.0 mV/ms vs. 54.0 ± 29.0 mV/ms) (P<0.001).
Conclusions The results showed significant differences between adult and pediatric ECG characteristics in rate, SA, and COND. These differences may result in inaccurate rhythm detection during AED use in children if the algorithm detection validation program did not include pediatric rhythms. This study confirms the recommendation that an AED rhythm algorithm should be validated with ECG strips obtained from children.