B Shock Advisory System - Stryker LIFEPAK 1000 Operating Instructions Manual

Shock Advisory System
A. Acquisition and Annotation Methodology
This section includes recording methods, rhythm source, rhythm selection criteria, annotation
methods, and annotation criteria for the Shock Advisory System test sets.
Physio-Control Test Set
The Physio-Control Test Set includes ECG segments gathered from a variety of sources. The
test set includes both adult and pediatric ECG segments, ECGs from the standard
anterior-lateral (AL, AA) defibrillation electrode placement, ECGs from anterior-posterior (AP)
defibrillation electrode placement, and ECGs from patients who have a pacemaker. Each ECG
segment is 10 seconds in duration. Sources for the ECGs include:
• AHA Ventricular Arrhythmia Database (Holter recordings)
• MIT-BIH Arrhythmia Database (Holter)
• MIT-BIH Malignant Ventricular Arrhythmia Database (Holter)
• Creighton University Ventricular Tachyarrhythmia Database (hospital monitor)
• A series of consecutive LIFEPAK 500 automated external defibrillator recordings collected by
Physio-Control
• DiMarco AA-AP ECG Database (simultaneous AA and AP defibrillation leads, recorded in the
electrophysiology laboratory)
• Vanderbilt Pediatric ECG Database (AA and/or AP defibrillation leads, recorded in the
pediatric intensive care unit, the pediatric electrophysiology laboratory, and the pediatric
operating room during open heart surgery)
• A series of 12-lead recordings from consecutive chest pain patients, recorded in the
pre-hospital setting with the LIFEPAK 11 monitor/defibrillator.
SAS Test Set
The SAS Test Set includes 65 ECG samples of shockable rapid ventricular tachycardia from
pulseless patients recorded during pre-hospital use of LIFEPAK 5 defibrillators by paramedics.
Selected ECG segments were sampled and the ECG rhythm was classified by clinical experts.
Each ECG segment is 5 seconds in duration.
B. ECG Rhythm Types
The ECG rhythms were placed into the following categories by the clinical experts.
Shockable
• Coarse ventricular fibrillation (VF) (>0.20 mV peak-to-peak amplitude)
• Rapid ventricular tachycardia, pulseless (VT) (HR >120 bpm, QRS duration >160 ms, no
apparent P waves, patient reported to be pulseless by paramedics)
Nonshockable
• Normal sinus rhythm (NSR) (sinus rhythm, heart rate 60-100 bpm)
• Asystole (<0.08 mV peak-to-peak amplitude)
• Other organized rhythms including 30 or more of each of the following rhythms: atrial fibrillation,
atrial flutter, 2nd degree atrioventricular block, 3rd degree atrioventricular block,
idioventricular rhythms, sinus bradycardia, supraventricular tachycardia, and rhythms with
premature ventricular complexes
B-2 LIFEPAK 1000 Defibrillator Operating Instructions