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Optimal defibrillation timing guided by ventricular fibrillation (VF) waveform analysis would contribute to improved survival of out-of-hospital cardiac arrest (OHCA) patients by minimizing myocardial damage caused by futile defibrillation shocks and minimizing interruptions to cardiopulmonary resuscitation. Recently, fuzzy entropy (FuzzyEn) tailored to jointly measure VF amplitude and regularity has been shown to be an efficient defibrillation success predictor. In this study, 734 shocks from 296 OHCA patients (50 survivors) were analyzed, and the embedding dimension (m) and matching tolerance (r) for FuzzyEn and sample entropy (SampEn) were adjusted to predict defibrillation success and patient survival. Entropies were significantly larger in successful shocks and in survivors, and when compared to the available methods, FuzzyEn presented the best prediction results, marginally outperforming SampEn. The sensitivity and specificity of FuzzyEn were 83.3% and 76.7% when predicting defibrillation success, and 83.7% and 73.5% for patient survival. Sensitivities and specificities were two points above those of the best available methods, and the prediction accuracy was kept even for VF intervals as short as 2s. These results suggest that FuzzyEn and SampEn may be promising tools for optimizing the defibrillation time and predicting patient survival in OHCA patients presenting VF.

Optimal defibrillation timing guided by ventricular fibrillation (VF) waveform analysis would contribute to improved survival of out-of-hospital cardiac arrest (OHCA) patients by minimizing myocardial damage caused by futile defibrillation shocks and minimizing interruptions to cardiopulmonary resuscitation. Recently, fuzzy entropy (FuzzyEn) tailored to jointly measure VF amplitude and regularity has been shown to be an efficient defibrillation success predictor. In this study, 734 shocks from 296 OHCA patients (50 survivors) were analyzed, and the embedding dimension (m) and matching tolerance (r) for FuzzyEn and sample entropy (SampEn) were adjusted to predict defibrillation success and patient survival. Entropies were significantly larger in successful shocks and in survivors, and when compared to the available methods, FuzzyEn presented the best prediction results, marginally outperforming SampEn. The sensitivity and specificity of FuzzyEn were 83.3% and 76.7% when predicting defibrillation success, and 83.7% and 73.5% for patient survival. Sensitivities and specificities were two points above those of the best available methods, and the prediction accuracy was kept even for VF intervals as short as 2s. These results suggest that FuzzyEn and SampEn may be promising tools for optimizing the defibrillation time and predicting patient survival in OHCA patients presenting VF.

Optimal defibrillation timing guided by ventricular fibrillation (VF) waveform analysis would contribute to improved survival of out-of-hospital cardiac arrest (OHCA) patients by minimizing myocardial damage caused by futile defibrillation shocks and minimizing interruptions to cardiopulmonary resuscitation. Recently, fuzzy entropy (FuzzyEn) tailored to jointly measure VF amplitude and regularity has been shown to be an efficient defibrillation success predictor. In this study, 734 shocks from 296 OHCA patients (50 survivors) were analyzed, and the embedding dimension (m) and matching tolerance (r) for FuzzyEn and sample entropy (SampEn) were adjusted to predict defibrillation success and patient survival. Entropies were significantly larger in successful shocks and in survivors, and when compared to the available methods, FuzzyEn presented the best prediction results, marginally outperforming SampEn. The sensitivity and specificity of FuzzyEn were 83.3% and 76.7% when predicting defibrillation success, and 83.7% and 73.5% for patient survival. Sensitivities and specificities were two points above those of the best available methods, and the prediction accuracy was kept even for VF intervals as short as 2s. These results suggest that FuzzyEn and SampEn may be promising tools for optimizing the defibrillation time and predicting patient survival in OHCA patients presenting VF.

Optimal defibrillation timing guided by ventricular fibrillation (VF) waveform analysis would contribute to improved survival of out-of-hospital cardiac arrest (OHCA) patients by minimizing myocardial damage caused by futile defibrillation shocks and minimizing interruptions to cardiopulmonary resuscitation. Recently, fuzzy entropy (FuzzyEn) tailored to jointly measure VF amplitude and regularity has been shown to be an efficient defibrillation success predictor. In this study, 734 shocks from 296 OHCA patients (50 survivors) were analyzed, and the embedding dimension (m) and matching tolerance (r) for FuzzyEn and sample entropy (SampEn) were adjusted to predict defibrillation success and patient survival. Entropies were significantly larger in successful shocks and in survivors, and when compared to the available methods, FuzzyEn presented the best prediction results, marginally outperforming SampEn. The sensitivity and specificity of FuzzyEn were 83.3% and 76.7% when predicting defibrillation success, and 83.7% and 73.5% for patient survival. Sensitivities and specificities were two points above those of the best available methods, and the prediction accuracy was kept even for VF intervals as short as 2s. These results suggest that FuzzyEn and SampEn may be promising tools for optimizing the defibrillation time and predicting patient survival in OHCA patients presenting VF.

Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricular fibrillation (VF), and recent studies suggest the efficacy of waveform indices that characterize the underlying non-linear dynamics of VF. In this study we introduce, adapt and fully characterize six entropy indices for VF shock outcome prediction, based on the classical definitions of entropy to measure the regularity and predictability of a time series. Data from 163 OHCA patients comprising 419 shocks (107 successful) were used, and the performance of the entropy indices was characterized in terms of embedding dimension (m) and matching tolerance (r). Six classical predictors were also assessed as baseline prediction values. The best prediction results were obtained for fuzzy entropy (FuzzEn) with m = 3 and an amplitude-dependent tolerance of r = 80 mu V. This resulted in a balanced sensitivity/specificity of 80.4%/76.9%, which improved by over five points the results obtained for the best classical predictor. These results suggest that a FuzzEn approach for a joint quantification of VF amplitude and its non-linear dynamics may be a promising tool to optimize OHCA treatment.

Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricular fibrillation (VF), and recent studies suggest the efficacy of waveform indices that characterize the underlying non-linear dynamics of VF. In this study we introduce, adapt and fully characterize six entropy indices for VF shock outcome prediction, based on the classical definitions of entropy to measure the regularity and predictability of a time series. Data from 163 OHCA patients comprising 419 shocks (107 successful) were used, and the performance of the entropy indices was characterized in terms of embedding dimension (m) and matching tolerance (r). Six classical predictors were also assessed as baseline prediction values. The best prediction results were obtained for fuzzy entropy (FuzzEn) with m = 3 and an amplitude-dependent tolerance of r = 80 mu V. This resulted in a balanced sensitivity/specificity of 80.4%/76.9%, which improved by over five points the results obtained for the best classical predictor. These results suggest that a FuzzEn approach for a joint quantification of VF amplitude and its non-linear dynamics may be a promising tool to optimize OHCA treatment.

Prediction of defibrillation success is of vital importance to guide therapy and improve the survival of patients suffering out-of-hospital cardiac arrest (OHCA). Currently, the most efficient methods to predict shock success are based on the analysis of the electrocardiogram (ECG) during ventricular fibrillation (VF), and recent studies suggest the efficacy of waveform indices that characterize the underlying non-linear dynamics of VF. In this study we introduce, adapt and fully characterize six entropy indices for VF shock outcome prediction, based on the classical definitions of entropy to measure the regularity and predictability of a time series. Data from 163 OHCA patients comprising 419 shocks (107 successful) were used, and the performance of the entropy indices was characterized in terms of embedding dimension (m) and matching tolerance (r). Six classical predictors were also assessed as baseline prediction values. The best prediction results were obtained for fuzzy entropy (FuzzEn) with m = 3 and an amplitude-dependent tolerance of r = 80 mu V. This resulted in a balanced sensitivity/specificity of 80.4%/76.9%, which improved by over five points the results obtained for the best classical predictor. These results suggest that a FuzzEn approach for a joint quantification of VF amplitude and its non-linear dynamics may be a promising tool to optimize OHCA treatment.