Diagnostic Accuracy of Commercially Available Automated External Defibrillators

<jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Although automated external defibrillators ( <jats:styled-content style="fixed-case">AED</jats:styled-content> s) have contributed to a better survival of out‐of‐hospital cardiac arrests, there have been reports of their malfunctioning. We investigated the diagnostic accuracy of commercially available <jats:styled-content style="fixed-case">AED</jats:styled-content> s using surface ECGs of ventricular fibrillation ( <jats:styled-content style="fixed-case">VF</jats:styled-content> ), ventricular tachycardia ( <jats:styled-content style="fixed-case">VT</jats:styled-content> ), and supraventricular tachycardia ( <jats:styled-content style="fixed-case">SVT</jats:styled-content> ). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> ECGs( <jats:styled-content style="fixed-case">VF</jats:styled-content> 31, <jats:styled-content style="fixed-case">VT</jats:styled-content> 48, <jats:styled-content style="fixed-case">SVT</jats:styled-content> 97) were stored during electrophysiological studies and transmitted to 4 <jats:styled-content style="fixed-case">AED</jats:styled-content> s, the LifePak <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus ( <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus), HeartStart <jats:styled-content style="fixed-case">FR</jats:styled-content> 3 ( <jats:styled-content style="fixed-case">FR</jats:styled-content> 3), and CardioLife <jats:styled-content style="fixed-case">AED</jats:styled-content> ‐2150 ( <jats:styled-content style="fixed-case">CL</jats:styled-content> 2150) and ‐9231 ( <jats:styled-content style="fixed-case">CL</jats:styled-content> 9231), through the pad electrode cables. For <jats:styled-content style="fixed-case">VF</jats:styled-content> , the <jats:styled-content style="fixed-case">CL</jats:styled-content> 2150 and <jats:styled-content style="fixed-case">CL</jats:styled-content> 9231 advised shocks in all cases, and the <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus and <jats:styled-content style="fixed-case">FR</jats:styled-content> 3 advised shocks in all but one <jats:styled-content style="fixed-case">VF</jats:styled-content> case. For <jats:styled-content style="fixed-case">VT</jats:styled-content> s faster than 180 bpm, the ratios for advising shocks were 79%, 36%, 89%, and 96% for the <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus, <jats:styled-content style="fixed-case">FR</jats:styled-content> 3, <jats:styled-content style="fixed-case">CL</jats:styled-content> 2150, and <jats:styled-content style="fixed-case">CL</jats:styled-content> 9231, respectively. The <jats:styled-content style="fixed-case">FR</jats:styled-content> 3 and <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus did not advise shocks for narrow <jats:styled-content style="fixed-case">QRS SVT</jats:styled-content> s, whereas the <jats:styled-content style="fixed-case">CL</jats:styled-content> 9231 tended to treat high‐rate tachycardias faster than 180 bpm even with narrow <jats:styled-content style="fixed-case">QRS</jats:styled-content> complexes. The characteristics of the shock advice for the <jats:styled-content style="fixed-case">FR</jats:styled-content> 3 differed from that for the <jats:styled-content style="fixed-case">CL</jats:styled-content> 9231 (kappa coefficient [κ]=0.479, <jats:italic>P</jats:italic> <0.001), and the <jats:styled-content style="fixed-case">CR</jats:styled-content> Plus and <jats:styled-content style="fixed-case">CL</jats:styled-content> 2150 had characteristics somewhere between the 2 former <jats:styled-content style="fixed-case">AED</jats:styled-content> s (κ=0.818, ...