Key result
A multimodal algorithm using ECG, ABP, and PPG achieved overall true positive rates of 95%/99% and true negative rates of 76%/80% for detecting false arrhythmia alarms.
Why the study?
Does a multimodal algorithm using ECG, ABP, and PPG improve the accuracy of arrhythmia alarms in the ICU?
Does a multimodal algorithm using ECG, ABP, and PPG improve the accuracy of arrhythmia alarms in the ICU?
A multimodal algorithm combining ECG, ABP, and PPG signals can effectively reduce false arrhythmia alarms in the ICU while maintaining high true positive rates.
May reduce false ICU arrhythmia alarms via multi-waveform HR estimation; leaves open prospective clinical validation.
The purpose of this study was to develop algorithms to lower the incidence of false arrhythmia alarms in the ICU using information from independent sources, namely electrocardiogram (ECG), arterial blood pressure (ABP) and photoplethysmogram (PPG). Our approach relies on robust adaptive signal processing techniques in order to extract accurate heart rate (HR) values from the different waveforms. Based on the quality of available signals, heart rate was either estimated from pulsatile waveforms using an adaptive frequency tracking algorithm or computed from ECGs using an adaptive mathematical morphology approach. Furthermore, we developed a supplementary measure based on the spectral purity of the ECGs to determine whether a ventricular tachycardia or flutter/fibrillation arrhythmia has taken place. Finally, alarm veracity was determined based on a set of decision rules on HR and spectral purity values. The proposed method was evaluated on the PhysioNet/CinC Challenge 2015 database, which is composed of 1250 life-threatening alarm recordings, each categorized into either bradycardia, tachycardia, asystole, ventricular tachycardia or ventricular flutter/fibrillation arrhythmia. This resulted in overall true positive rates of 95%/99% and overall true negative rates of 76%/80% on the real-time and retrospective subsets of the test dataset, respectively.
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Fallet et al. (2016) studied False arrhythmia alarms in the ICU (n=1,250). Multimodal algorithm using ECG, ABP, and PPG was evaluated on True positive and true negative rates for alarm veracity. A multimodal algorithm using ECG, ABP, and PPG achieved overall true positive rates of 95%/99% and true negative rates of 76%/80% for detecting false arrhythmia alarms.
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