Changes in the frequency spectrum, the P-P interval, and the bispectral index during ventricular fibrillation are physiologic indicators of ventricular fibrillation duration

Abstract

The 3-phase time-sensitive model by Weisfeldt and Becker in 2002 has resulted in a redirection of efforts toward developing treatment algorithms specific to each phase of cardiac arrest. In this study, a number of physiologic indicators of ventricular fibrillation (VF) duration were investigated. The bispectral index was recorded at 15-second intervals over 12 minutes and recordings of the atrial electrocardiogram and lead II electrocardiogram were acquired simultaneously using Notocord data acquisition software during sinus rhythm, ventricular tachycardia, and VF, and analyzed using a total of 30 porcine models. A number of frequency markers (fast Fourier transform and density and amplitude of peaks [DA]) were derived. There was a direct relationship between VF duration and bispectral index with a Pearson correlation coefficient (mean) of r = −0.91. The P-P interval recorded in the atria during VF, demonstrated similar findings ( r = 0.97) when measured against VF duration. It was interesting to note that P waves were still apparent during VF despite the on-going chaotic activity in the ventricles. The DA was calculated for each episode of prolonged VF and an exponential relationship with VF duration was observed. The dominant frequency during VF, DA, the P-P interval, and the BIS index are all potential physiologic indicators of VF duration.