Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
권호 표지
DOI QR코드

DOI QR Code

Design of CPR Artifact Removal Algorithm Based on Orthogonal Function using LMS Adaptive Filter

LMS 적응필터를 이용한 직교 함수 기반의CPR 잡음 제거 알고리즘 설계

  • Received : 2016.08.01
  • Accepted : 2016.10.11
  • Published : 2016.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study proposes an algorithm for removal of CPR artifact in order that automated external defibrillator (AED) can effectively diagnose ECG rhythm during cardiopulmonary resuscitation (CPR). Current AED required to interrupt chest compression for reliable rhythm analysis to avoid the effect of artifacts produced by CPR. However even temporarily interruption of chest compression during CPR adversely affects the probability of restoration of spontaneous circulation (ROSC) and survival after the delivery of the shock. Therefore, we proposed a method for removal of CPR artifacts using least mean square (LMS) filter. The removal of the CPR artifacts would enable compressions to continue during AED rhythm analysis, thereby increasing the likelihood of resuscitation success. It was tested on 31 segments of shockable and 300 segments of non-shockable ECG signals recorded from three pigs during CPR. In the result, sensitivity (Se) and specificity (Sp) analysis on the test segments showed values of Se = 3.2%, Sp = 66.0% and Se = 96.8%, Sp = 98.7% in the case of unfiltered and filtered signals during CPR. In conclusion, it was shown that the proposed method can be a useful tool to exactly diagnose the ECG rhythm during the CPR.

Keywords

References

  1. Go AS, "Heart Disease and Stroke Statistics-2013 Update", American Heart Association, 2013.
  2. Herlitz J, Bang A, Holmberg M, Axelsson, A, Lindkvist, J and Holmberg S, "Rhythm changes during resuscitation from ventricular fibrillation in relation to delay until defibrillation, number of shocks delivered and survival", Resuscitation, vol. 34, no. 1, pp. 17-22, 1997. https://doi.org/10.1016/S0300-9572(96)01064-7
  3. Snyder D and Morgan C, "Wide variation in cardiopulmonary resuscitation interruption intervals among commercially available automated external defibrillators may affect survival despite high defibrillation efficacy", Critical care medicine, vol. 32, no. 9, pp. 421-424, 2004. https://doi.org/10.1097/01.CCM.0000108875.35298.D2
  4. Ruiz DG, Sofia, Irusta U, Ruiz J, Ayala U, Aramendi E, and EftestOl T, "Rhythm analysis during cardiopulmonary resuscitation: past, present, and future", BioMed research international, 2014.
  5. Li Y, Bisera J, Geheb F, Tang W and Weil MH, "Identifying potentially shockable rhythms without interrupting cardiopulmonary resuscitation", Critical Care Medicine, vol. 36, no. 1, pp. 198-203, 2008. https://doi.org/10.1097/01.CCM.0000295589.64729.6B
  6. EilevstjOnn J, EftestOl T, Aase SO, Myklebust H, HusOy JH and Steen PA, "Feasibility of shock advice analysis during CPR through removal of CPR artefacts from the human ECG", Resuscitation, vol. 61, no. 2, pp. 131-141, 2004. https://doi.org/10.1016/j.resuscitation.2003.12.019
  7. Rheinberger K, Steinberger T, Unterkofler K, Baubin M, Klotz A and Amann A, "Removal of CPR artifacts from the ventricular fibrillation ECG by adaptive regression on lagged reference signals", IEEE Transactions on Biomedical Engineering, vol. 55, no. 1, pp. 130-137, 2008. https://doi.org/10.1109/TBME.2007.902235
  8. Werther T, Klotz A, Kracher G, Baubin M, Feichtinger HG, Gilly H and Amann A, "CPR artifact removal in ventricular fibrillation ECG signals using gabor multipliers", IEEE Transactions on Biomedical Engineering, vol. 56, no. 2, pp. 320-327, 2009. https://doi.org/10.1109/TBME.2008.2003107
  9. Ruiz DG, Ruiz J, Irusta, U, Aramendi E, EftestOl T and Kramer-Johansen J, "A method to remove CPR artefacts from human ECG using only the recorded ECG", Resuscitation, vol. 76, no. 2, pp. 271-278, 2008. https://doi.org/10.1016/j.resuscitation.2007.08.002
  10. Aramendi E, Ayala, U, Irusta, U, Alonso E, EftestOl T and Kramer-Johansen, J, "Suppression of the cardiopulmonary resuscitation artefacts using the instantaneous chest compression rate extracted from the thoracic impedance", Resuscitation, vol. 83, no. 6, pp. 692-698, 2012. https://doi.org/10.1016/j.resuscitation.2011.11.029
  11. Nam DH, Kang DW, Myoung HS and Lee KJ, "Detection Method for Shockable Rhythm Based on a Single Feature", Electronics Letters, vol. 52, no. 9, pp. 686-688, 2016. https://doi.org/10.1049/el.2016.0344
  12. Kuo S and Dillman R, "Computer detection of ventricular fibrillation", Computers in Cardiology, pp. 2747-2750, 1978
  13. Goldberger A L, Amaral LA, Glass L, Hausdorff JM, Ivanov PC, Mark RG and Stanley HE, "Physiobank, physiotoolkit, and physionet components of a new research resource for complex physiologic signals", Circulation, vol. 101, no. 23, pp. 215-220, 2000. https://doi.org/10.1161/01.CIR.101.23.e215
  14. Grundler WG, Weil MH, Miller JM and Rackow EC, "Observations on colloid osmotic pressure, hematocrit, and plasma osmolality during cardiac arrest", Critical Care Medicine, vol. 13, no. 11, pp. 895-896, 1985. https://doi.org/10.1097/00003246-198511000-00007