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Analyse de signaux d'arrêts cardiaques en cas d'intervention d'urgence avec défibrillateur automatisé : optimisation des temps de pause péri-choc et prédiction d'efficacité de défibrillation

Abstract : The cardiac arrest is mainly of cardiovascular etiology. In the actual context of out-of-hospital cardiac arrests, 20 to 25% of the victims present a ventricular fibrillation. About 3 to 5% of the victims are saved without neurological damage. The chance of surviving a cardiac arrest outside an hospital depends on the early and fast support of the victim. The first active witnesses performing cardiopulmonary resuscitation combined with the use of a defibrillator are an important link to save the victim. Our main objective is to improve survival rate in out-of-hospital cardiac arrest cases. A first way of investigation is to propose an optimal functioning of defibrillator combining wisely the different processes of detection embedded (ventricular fibrillation detection, chest compressions detection, electromagnetic interferences detection), in order to reduce the peri-shock pauses during the resuscitation procedure. In fact, during these pauses, known as "hands-off" pauses, no emergency action is provided to the patient, what is correlated to a drop of the coronary pression, but also to a decrease of the chance of successful defibrillation. That is the reason why, a second way of investigation is based on the prediction of the efficiency of defibrillation. In this context, we propose to use a combination of parameters extracted from electrocardiogram in time, frequency and non-linear dynamics domains. A bayesian classifier using a gaussian mixture model was applied to the vectors of parameters, which are the most predictor of the defibrillation outcome and the algorithm Expectation-Maximization allowed to learn the parameters of the probabilistic model representing the class conditional distributions. All of the proposed methods allowed to reach promising results for both reducing the peri-shock pauses and predicting the efficiency of defibrillation in hope to improve the survival rate in cardiac arrest cases
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Theses
File URL :
http://docnum.univ-lorraine.fr/prive/SCD_T_2011_0120_MENETRE.pdf
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https://hal.univ-lorraine.fr/tel-01746267
Contributor : Thèses Ul <>
Submitted on : Thursday, March 29, 2018 - 10:29:33 AM
Last modification on : Tuesday, October 13, 2020 - 10:46:06 AM

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  • HAL Id : tel-01746267, version 1

Citation

Sarah Ménétré. Analyse de signaux d'arrêts cardiaques en cas d'intervention d'urgence avec défibrillateur automatisé : optimisation des temps de pause péri-choc et prédiction d'efficacité de défibrillation. Médecine humaine et pathologie. Université Henri Poincaré - Nancy 1, 2011. Français. ⟨NNT : 2011NAN10120⟩. ⟨tel-01746267⟩

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