Abstract 10250: Comparison of Electrocardiographic Characteristics for Automated External Defibrillator Algorithms in Children and Adults
Background: An automated external defibrillator (AED) is recommended for rhythm detection during cardiac arrest for children < 8 years if the algorithm has been validated in children. We have previously reported that the ECG characteristics rate (HR), QRS amplitude (AMP) and conduction velocity (CV) of normal sinus rhythm (NSR) differ between children and adults. We hypothesized that these ECG characteristics of potential cardiac arrest rhythms are different between pediatric and adult ECGs.
Methods: Digitized recordings of NSR, supraventricular tachycardia (SVT), and ventricular tachycardia (VT) were obtained from PhysioNet's publically available database, and the ZOLL pediatric database. Rhythm strips of at least 3 sec were evaluated from 199 children and 170 adults (> 36,000 QRS complexes). HR and AMP were determined by R-R interval detection and peak to peak QRS measurements. CV was defined as maximum QRS slope from the first major deflection; SVT was defined as a narrow complex tachycardia without P waves and rate > 150 bpm. VT was any wide-complex tachycardia. Differences were defined by t-testing.
Conclusions: Significant differences exist between adult and pediatric ECG characteristics of both normal and potential cardiac arrest rhythms. The most significant differences were demonstrated among adult and pediatric HR and AMP for NSR and SVT. CV demonstrates less variability between adult and pediatric rhythms. No differences were detected for VT characteristics. If the detection algorithm does not include pediatric rhythms children may receive inappropriate shocks. This study confirms the recommendation that an AED rhythm algorithm be validated with ECG strips obtained from children.
- © 2010 by American Heart Association, Inc.