ECG-Based classification of resuscitation cardiac rhythms for retrospective data analysis

Ali Bahrami Rad*, Trygve Eftestol, Kjersti Engan, Unai Irusta, Jan Terje Kvaloy, Jo Kramer-Johansen, Lars Wik, Aggelos K. Katsaggelos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

52 Scopus citations


Objective: There is a need to monitor the heart rhythm in resuscitation to improve treatment quality. Resuscitation rhythms are categorized into: ventricular tachycardia (VT), ventricular fibrillation (VF), pulseless electrical activity (PEA), asystole (AS), and pulse-generating rhythm (PR). Manual annotation of rhythms is time-consuming and infeasible for large datasets. Our objective was to develop ECG-based algorithms for the retrospective and automatic classification of resuscitation cardiac rhythms. Methods: The dataset consisted of 1631 3-s ECG segments with clinical rhythm annotations, obtained from 298 out-of-hospital cardiac arrest patients. In total, 47 wavelet- and time-domain-based features were computed from the ECG. Features were selected using a wrapper-based feature selection architecture. Classifiers based on Bayesian decision theory, k-nearest neighbor, k-local hyperplane distance nearest neighbor, artificial neural network (ANN), and ensemble of decision trees were studied. Results: The best results were obtained for ANN classifier with Bayesian regularization backpropagation training algorithm with 14 features, which forms the proposed algorithm. The overall accuracy for the proposed algorithm was 78.5%. The sensitivities (and positive-predictive-values) for AS, PEA, PR, VF, and VT were 88.7% (91.0%), 68.9% (70.4%), 65.9% (69.0%), 86.2% (83.8%), and 78.8% (72.9%), respectively. Conclusions: The results demonstrate that it is possible to classify resuscitation cardiac rhythms automatically, but the accuracy for the organized rhythms (PEA and PR) is low. Significance: We have made an important step toward making classification of resuscitation rhythms more efficient in the sense of minimal feedback from human experts.

Original languageEnglish (US)
Article number7890478
Pages (from-to)2411-2418
Number of pages8
JournalIEEE Transactions on Biomedical Engineering
Issue number10
StatePublished - Oct 2017


  • Cardiac arrest
  • cardiac rhythm classification
  • cardiopulmonary resuscitation
  • feature extraction/selection
  • nested cross-validation

ASJC Scopus subject areas

  • Biomedical Engineering


Dive into the research topics of 'ECG-Based classification of resuscitation cardiac rhythms for retrospective data analysis'. Together they form a unique fingerprint.

Cite this