• Johan Israelsson, Burkard von Wangenheim, Kristofer Årestedt, Birgitta Semark, Kristina Schildmeijer, and Jörg Carlsson.
• Department of Internal Medicine, Division of Cardiology, Kalmar County Hospital, SE-39185 Kalmar, Sweden; Kalmar Maritime Academy, Linnaeus University, Kalmar, Sweden; Department of Medical and Health Sciences, Division of Nursing Science, Linköping University, Linköping, Sweden. Electronic address: johani@ltkalmar.se.
• Resuscitation. 2017 Nov 1; 120: 108-112.

AimThe aim was to investigate the clinical performance of two different types of automated external defibrillators (AEDs).MethodsThree investigators reviewed 2938 rhythm analyses performed by AEDs in 240 consecutive patients (median age 72, q1-q3=62-83) who had suffered cardiac arrest between January 2011 and March 2015. Two different AEDs were used (AED A n=105, AED B n=135) in-hospital (n=91) and out-of-hospital (n=149).ResultsAmong 194 shockable rhythms, 17 (8.8%) were not recognized by AED A, while AED B recognized 100% (n=135) of shockable episodes (sensitivity 91.2 vs 100%, p<0.01). In AED A, 8 (47.1%) of these episodes were judged to be algorithm errors while 9 (52.9%) were caused by external artifacts. Among 1039 non-shockable rhythms, AED A recommended shock in 11 (1.0%), while AED B recommended shock in 63 (4.1%) of 1523 episodes (specificity 98.9 vs 95.9, p<0.001). In AED A, 2 (18.2%) of these episodes were judged to be algorithm errors (AED B, n=40, 63.5%), while 9 (81.8%) were caused by external artifacts (AED B, n=23, 36.5%).ConclusionsThere were significant differences in sensitivity and specificity between the two different AEDs. A higher sensitivity of AED B was associated with a lower specificity while a higher specificity of AED A was associated with a lower sensitivity. AED manufacturers should work to improve the algorithms. In addition, AED use should always be reviewed with a routine for giving feedback, and medical personnel should be aware of the specific strengths and shortcomings of the device they are using.Copyright © 2017 Elsevier B.V. All rights reserved.

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