Abstract

This work proposes a learning model to predict the outcome of electrical defibrillation from ECG signals in ventricular fibrillation (VF) periods, which is a lethal situation happening when a patient is suffering cardiac arrest. An animal experiment of rats is conducted to obtain the ECG signals and necessary information for this study. This proposed model only extracts one feature from the ECG signals and enjoys low computational complexity at both training and testing stages. The statistics of this extracted single feature is further analyzed, and mathematical closed-form formulas for several interesting performance indices including the sensitivity, specificity, accuracy, precision and Area Under the Curve (AUC) are obtained to gain more insights of the proposed system. Moreover, the extracted feature can be treated as a linear combination of individual frequency components of the ECG signal, where the combining coefficients of the linear combination may show informative clinical inference. Frequencies corresponding to large trained combining coefficients imply that they contribute more in distinguishing the defibrillation outcome, and vice versa. As a result, important frequencies of the ECG signals can be identified and insignificant frequencies can also be filtered out by the proposed training. Simulation results corroborate the analytical results, and show that the proposed scheme greatly outperforms several competitive learning models and traditional methods in terms of testing accuracy and computational complexity.

Highlights

  • T O provide first aid to the patient who is suffering out-ofhospital cardiac arrest (OHCA), paramedics implement cycles of cardiopulmonary resuscitation (CPR) followed by electrical defibrillation

  • One exception is principal component analysis (PCA) without truncation + LDC, which has an accuracy of 79.8% and an Area Under the Curve (AUC) of 0.87 from Tab

  • We have proposed a learning model that extracts only one feature to predict the outcome of electrical defibrillation

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Summary

INTRODUCTION

T O provide first aid to the patient who is suffering out-ofhospital cardiac arrest (OHCA), paramedics implement cycles of cardiopulmonary resuscitation (CPR) followed by electrical defibrillation. A method called detrended fluctuation analysis (DFA) was proposed in [14] to predict the result of first-shock defibrillation. The authors analyzed the variance of ECG in [15] and proposed a neural network model in [16] for first-shock result prediction. We propose a new learning model to predict the electrical defibrillation outcome. The feature extraction module can be treated as an equivalent system that linearly combines the frequency domain components of the input ECG signal. The values of weights for frequency at 0 Hz and 60 Hz are small, which correspond to DC (direct current) and harmonic of electrical supply This means that the proposed training model “filters out” these large interference sources irrelevant to the decision. 294 of them are labeled as fail and 67 as success; while in the testing data, 192 are labeled as fail and 18 as success

Preprocessing
Feature Extraction
Classification
SYSTEM PARAMETERS AND THEORETICAL MODEL
Preserved Features
Threshold for Truncation
Theoretical Model of the Proposed System
SIMULATION RESULT
Findings
CONCLUSIONS AND FUTURE WORKS

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