Ecg rhythm analysis algorithm accuracy – ZOLL R Series Monitor Defibrillator Rev J User Manual

Page 531

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ECG Rhythm Analysis Algorithm Accuracy

9650-0912-01 Rev. K

ZOLL R Series Operator’s Guide

A–29

ECG Rhythm Analysis Algorithm Accuracy

Sensitivity and specificity are expressions of ECG rhythm analysis algorithm performance
when compared to ECG interpretation by a clinician or expert. Sensitivity refers to the
algorithm’s ability to correctly identify shockable rhythms (as a percentage of the total number
of shockable rhythms). Specificity refers to the algorithm’s ability to correctly identify
nonshockable rhythms (as a percentage of the total number of nonshockable rhythms).

The data in Table A-4 and Table A-5 summarize the accuracy of the ECG rhythm analysis
algorithm as tested against ZOLL’s ECG rhythm database. Rhythm sources included data
records from ZOLL devices and public domain databases recorded with electrode systems and
ECG signal processing characteristics similar to the R Series. Data records were of appropriate
length to allow for satisfactory analysis.

The algorithm sequence takes approximately 9 seconds and proceeds as follows:

Divides the ECG rhythm into 3-second segments

Filters and measures noise, artifact, and baseline wander

Measures baseline content (“waviness” at the correct frequencies – frequency domain
analysis) of signal

Measures QRS rate, width, and variability

Measures amplitude and temporal regularity (autocorrelation) of peaks and troughs

Determines if multiple 3-second segments are shockable and then prompts the operator to
treat the patient

Table A-4.

Clinical Performance Results (Adult Patients)

Rhythms

Sample

Size

Performance

Goals

Observed

Performance

90% One-sided Lower

Confidence Limit

Shockable

Sensitivity

Coarse VF

536

>90%

100.0%

99.4%

Rapid VT

80

>75%

100.0%

96.3%

Nonshockable Specificity

NSR

2210

>99%

100.0% 99.9%

AF, SB, SVT, heart block,
idioventricular, PVCs

819

>95%

99.9% 99.4%

Asystole

115

>95%

100.0% 97.4%

Intermediate

Fine VF

69

Report only

89.9%

81.8%

Other VT

28

Report only

96.4%

84.2%

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