Projected impact of an AI-guided defibrillation and cardioversion decision support system: A fully synthetic, simulation-based randomized trial for a tertiary care hospital in India.

Background: Survival from in-hospital cardiac arrest caused by ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) decreases with every minute of delay before defibrillation. Conventional shock decisions depend on clinician recognition, guideline recall, team coordination, and s...

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Publicado en:Critical Care & Shock Vol. 29; no. 4; pp. 151 - 163
Autores principales: Jamadar, Khurshid, Shikalgar, Shahin Faruk, Suryavanshi, Surekha Kisan, Tapare, Shrikant, Pore, Yashashri, Pimpalekar, Shital, Nadaf, Husain, Jabade, Mangesh
Formato: equations & formulas research tables/charts randomized controlled trial Journal Article
Publicado: Critical Care & Shock Journal 2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 2026
      vid: 29
      iid: 4
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      pub: Critical Care & Shock Journal
      place: Houston, Texas
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        atl: Projected impact of an AI-guided defibrillation and cardioversion decision support system: A fully synthetic, simulation-based randomized trial for a tertiary care hospital in India.
      aug:
        au:
          Jamadar, Khurshid
          Shikalgar, Shahin Faruk
          Suryavanshi, Surekha Kisan
          Tapare, Shrikant
          Pore, Yashashri
          Pimpalekar, Shital
          Nadaf, Husain
          Jabade, Mangesh
        affil: Dr. D. Y. Patil Vidyapeeth, Pune, Dr. D. Y. Patil College of Nursing, Pimpri, Pune, India
      sug:
        subj:
          Artificial Intelligence
          Defibrillation
          Cardioversion
          Decision Support Systems, Clinical
          Computer Simulation
          Tertiary Health Care India
          Academic Medical Centers India
          Resuscitation, Cardiopulmonary
          Treatment Outcomes
          Heart Arrest Therapy
          Time
          Ventricular Fibrillation Therapy
          Tachycardia, Ventricular Therapy
          Human
          Randomized Controlled Trials
          Random Assignment
          Comparative Studies
          Male
          Female
          Middle Age
          Aged
          India
          Cardiac Patients
          Hospitals, Special
          Arrhythmia Classification
          Hand Off (Patient Safety)
          Return of Spontaneous Circulation
          Heart Arrest Prognosis
          Survival Analysis
          Patient Discharge
          Descriptive Statistics
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Survival from in-hospital cardiac arrest caused by ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) decreases with every minute of delay before defibrillation. Conventional shock decisions depend on clinician recognition, guideline recall, team coordination, and standard shock-advisory algorithms that may require interruptions in chest compressions. Recent advances in artificial intelligence (AI) have demonstrated high accuracy in rhythm recognition and shock advisory during cardiopulmonary resuscitation (CPR), but their potential impact in Indian tertiary-care settings remains uncertain. Objective: To estimate the potential effect of an AI-guided defibrillation and cardioversion decision-support system on time-to-first shock and resuscitation outcomes using a fully synthetic simulation model based on a tertiarycare hospital setting. Methods: A virtual randomized trial comprising 2,000 synthetic adult episodes (1,000 per arm) was constructed. Cases included shockable cardiac arrest (VF/pVT) and unstable tachyarrhythmias requiring synchronized cardioversion. Standard care was compared with an AI-assisted model providing real-time rhythm classification, shock/no-shock recommendations, energy suggestions, and prompts to minimize CPR interruptions while preserving clinician authority. The primary outcome was time-to-first shock. Secondary outcomes included firstshock success, CPR hands-off time, return of spontaneous circulation (ROSC), survival to discharge, neurological outcome proxy, and number of shocks. Results: Mean time-to-first shock decreased from 5.5±2.3 minutes to 3.7±1.6 minutes with AI assistance (mean reduction 1.8 minutes, p<0.001). First-shock success increased from 62.0% to 78.2%, CPR hands-off time decreased substantially, ROSC improved from 50.3% to 60.3%, and survival to discharge increased from 24.6% to 29.3%. Conclusion: This simulation suggests that AI-assisted defibrillation and cardioversion may reduce treatment delays, improve CPR quality, and enhance resuscitation outcomes. Prospective clinical studies are required to validate these findings before implementation in practice.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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