Is arrhythmia detection by automatic external defibrillator accurate for children? Sensitivity and specificity of an automatic external defibrillatoralgorithm in 696 pediatric arrhythmias

Background-Use of automatic external defibrillators (AEDs) in children aged <8 years is not recommended, The purpose of this study was to develop an E CG database of shockable and nonshockable rhythms from a broad age range of pediatric patients and to test the accuracy of the Agilent Heartstream FR2 Patient Analysis System for sensitivity and specificity. Methods and Results-Children aged <less than or equal to>12 years who eithe r developed arrhythmias or were at risk for developing arrhythmias were stu died. Two sources were used for the database: children whose rhythms were r ecorded prospectively via a modified AED and children who had arrhythmias c aptured on paper and digitized for subsequent analysis. The rhythms were di vided into 5-second strips, classified by 3 reviewers, and then assessed by the AED analysis algorithm. A total of 696 five-second rhythm strips from 191 children (81 female and 110 male) aged 1 day to 12 years (median 3.0 ye ars) were analyzed. There was 100% specificity for nonshockable rhythms. Se nsitivity for ventricular fibrillation was 96%. Conclusions-There was excellent AED rhythm analysis sensitivity and specifi city in all age groups for ventricular fibrillation and nonshockable rhythm s. The high specificity and sensitivity indicate that there is a very low r isk of an inappropriate shock and that the AED correctly identifies shockab le rhythms, making the algorithm both safe and effective for children.