Irregularity test for very short electrocardiogram (ECG) signals as a method for predicting a successful defibrillation in patients with ventricular fibrillation.

A significant proportion of patients with ventricular fibrillation (VF) can only be defibrillated after a period of chest compressions and ventilation before the defibrillation attempt. In these patients, unsuccessful defibrillations increase the duration of heart arrest and reduce the possibility of a successful resuscitation, which could be avoided if a reliable prediction for the success of defibrillation could be made. A new method is presented for estimating the irregularity in very short electrocardiographic (ECG) recordings that enables the prediction of a successful defibrillation in patients with VF. This method is based on a recently developed determinism test for very short time series. A slight modification shows that the method can be used to determine relative differences in irregularity of the studied signals. In particular, ECG recordings of VF from patients who could be successfully defibrillated are characterized by a higher level of irregularity, indicating a chaotic nature of the dynamics of the heart, which is in agreement with previous studies on long ECG recordings showing that cardiac chaos was prevalent in healthy heart, whereas in severe congestive heart failure, a decrease in the chaotic behavior was observed.

[1]  A. Panfilov,et al.  Spiral breakup as a model of ventricular fibrillation. , 1998, Chaos.

[2]  Schreiber,et al.  Improved Surrogate Data for Nonlinearity Tests. , 1996, Physical review letters.

[3]  Matthew J Reed,et al.  Analysing the ventricular fibrillation waveform. , 2003, Resuscitation.

[4]  K. Birmingham.  What is translational research? , 2002, Nature Medicine.

[5]  A. Amann,et al.  Algorithms to analyze ventricular fibrillation signals , 2001, Current opinion in critical care.

[6]  J E Skinner,et al.  A reduction in the correlation dimension of heartbeat intervals precedes imminent ventricular fibrillation in human subjects. , 1993, American heart journal.

[7]  R. Gazmuri,et al.  Ventricular fibrillation waveform analysis for guiding the time of electrical defibrillation. , 2001, Critical care medicine.

[8]  J. Nolan,et al.  European Resuscitation Council Guidelines 2000 for Adult Advanced Life Support. A statement from the Advanced Life Support Working Group(1) and approved by the Executive Committee of the European Resuscitation Council. , 2001, Resuscitation.

[9]  Y. Sato,et al.  High-energy defibrillation increases the severity of postresuscitation myocardial dysfunction. , 1997, Circulation.

[10]  L. J. Leon,et al.  Spatiotemporal evolution of ventricular fibrillation , 1998, Nature.

[11]  Michael Small,et al.  Deterministic nonlinearity in ventricular fibrillation. , 2000, Chaos.

[12]  M. Copass,et al.  Amplitude of ventricular fibrillation waveform and outcome after cardiac arrest. , 1985, Annals of internal medicine.

[13]  S. O. Aase,et al.  Predicting Outcome of Defibrillation by Spectral Characterization and Nonparametric Classification of Ventricular Fibrillation in Patients With Out-of-Hospital Cardiac Arrest , 2000, Circulation.

[14]  Wanchun Tang,et al.  Ventricular fibrillation voltage as a monitor of the effectiveness of cardiopulmonary resuscitation. , 1994, The Journal of laboratory and clinical medicine.

[15]  P-M Binder,et al.  Determinism test for very short time series. , 2005, Physical review. E, Statistical, nonlinear, and soft matter physics.

[16]  E Otero-Siliceo,et al.  Is it healthy to be chaotic? , 2003, Medical hypotheses.

[17]  Mauricio Barahona,et al.  Detection of nonlinear dynamics in short, noisy time series , 1996, Nature.

[18]  J. A. Stewart,et al.  Nonlinear Time Series Analysis , 2015 .

[19]  Holger Kantz,et al.  Human ECG: nonlinear deterministic versus stochastic aspects , 1998, chao-dyn/9807002.

[20]  Chi-Sang Poon,et al.  Decrease of cardiac chaos in congestive heart failure , 1997, Nature.

[21]  M. Perc.  Nonlinear time series analysis of the human electrocardiogram , 2005 .

[22]  M. Copass,et al.  Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation , 1999, JAMA.

[23]  H U Strohmenger,et al.  Analysis of the ventricular fibrillation ECG signal amplitude and frequency parameters as predictors of countershock success in humans. , 1997, Chest.

[24]  D. T. Kaplan,et al.  Is fibrillation chaos? , 1990, Circulation research.

[25]  Michael Small,et al.  Measuring temporal complexity of ventricular fibrillation , 2000 .

[26]  A Garfinkel,et al.  Controlling cardiac chaos. , 1992, Science.