Application of entropy-based features to predict defibrillation outcome in cardiac arrest

Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricula...

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Detalles Bibliográficos
Autores: Chicote Gutiérrez, Beatriz, Irusta Zarandona, Unai, Alcaraz, Raúl, Rieta, José Joaquín, Aramendi Ecenarro, Elisabete, Isasi Liñero, Iraia, Alonso, Daniel, Ibarguren Olalde, Karlos
Tipo de recurso: artículo
Fecha de publicación:2016
País:España
Institución:Universidad del País Vasco
Repositorio:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/26715
Acceso en línea:http://hdl.handle.net/10810/26715
Access Level:acceso abierto
Palabra clave:ventricular fibrillation
defibrillation
shock outcome prediction
out-of-hospital cardiac arrest
non-linear dynamics
entropy measures
regularity-based entropies
predictability-based entropies
fuzzy entropy
Descripción
Sumario:Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricular fibrillation (VF), and recent studies suggest the efficacy of waveform indices that characterize the underlying non-linear dynamics of VF. In this study we introduce, adapt and fully characterize six entropy indices for VF shock outcome prediction, based on the classical definitions of entropy to measure the regularity and predictability of a time series. Data from 163 OHCA patients comprising 419 shocks (107 successful) were used, and the performance of the entropy indices was characterized in terms of embedding dimension (m) and matching tolerance (r). Six classical predictors were also assessed as baseline prediction values. The best prediction results were obtained for fuzzy entropy (FuzzEn) with m = 3 and an amplitude-dependent tolerance of r = 80 mu V. This resulted in a balanced sensitivity/specificity of 80.4%/76.9%, which improved by over five points the results obtained for the best classical predictor. These results suggest that a FuzzEn approach for a joint quantification of VF amplitude and its non-linear dynamics may be a promising tool to optimize OHCA treatment.