A case of a patient with ventricular fibrillation, in which the AED did not assess as shockable until the 4th analysis

DOI DOI 1 Citations 15 References
  • Ushita Misuzu
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Kohayagawa Yoshitaka
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Niinou Norio
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Koshizaki Masayuki
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Yamamori Yuji
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Sasaki Akira
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital
  • Matsubara Yasuhiro
    Department of Emergency and Critical Care Medicine, Shimane Prefectural Hospital

Bibliographic Information

Other Title
  • ＡＥＤの心電図解析４回目で除細動適応と判定された心室細動の１例
  • 次亜塩素酸ナトリウムを含むトイレ洗浄剤飲用による急性呼吸促迫症候群の１例
  • Acute Respiratory Distress Syndrome Caused by Ingestion of a Toilet-Bowl Cleaner Containing Sodium Hypochlorite

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A 56-year-old man had a sudden cardiac arrest when he was playing table tennis. A medical student administered bystander cardiopulmonary resuscitation to him and activated the emergency medical service system. When the ambulance officers arrived, the patient's cardiac rhythm registered ventricular fibrillation (VF) on the automated external defibrillator (AED) monitor. However, the first through third AED analysis was not recognized as VF. The cardiac rhythm was analyzed as VF during the fourth analysis and defibrillation was performed. After the shock, the patient's spontaneous circulation resumed. He was discharged without any complications. We found 99% stenosis in his right coronary artery caused the patient's VF. Because various companies make AED software, there is slight variance in AED analysis. However all AED software must meet compliance standards proposed by the American Heart Association as well as Association for the Advancement of Medical Instrumentation. Software sensitivity is not exactly 100% because some sacrifice in sensitivity is necessary to reach adequate specificity. Health care practitioners should be aware that AED software sensitivity is not 100% perfect. Therefore, in cases where the AED doesn't fix the problem, adequate cardiopulmonary resuscitation should be performed.

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