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This study investigated whether arterial blood gas (ABG) parameters could predict optimal defibrillation energy requirements for achieving the highest first-shock success rates in an animal model. Our study focused on clinical scenarios where ABG measurements are readily available, such as ventricular tachycardia and ventricular fibrillation storms requiring multiple shock deliveries. Materials and Methods: In the experimental setting, ventricular fibrillation was induced by 50 Hz direct current (DC), and the defibrillation threshold (DFT) was determined using a stepwise defibrillation protocol. ABG parameters were measured before each defibrillation attempt, recording partial arterial pressure of carbon dioxide (PaCO2) and oxygen (PaO2), pH, hematocrit (Hct), sodium (Na+), potassium (K+), and bicarbonate (HCO3\u2212) levels. The relationships between ABG parameters and the DFT were analyzed for 15 subjects using classical data analysis techniques and machine learning (ML) algorithms. Multiple ML models were trained and tested to predict the higher energy needed for successful defibrillation based on the ABG parameters. Results: Statistically significant differences were found in Hct and Na+ levels between the two DFT categories, above 130 Joules (J) and below 40 J (p &lt; 0.01). The DFT negatively correlated with PaO2 and positively correlated with Hct and Na+. However, other ABG parameters did not show significant correlations with DFT. Using ML, we predicted cases requiring higher defibrillation E. Our best-performing model, the Extra Trees Classifier, achieved 83% overall accuracy, with 100% and 67% precision rates for higher and lower DFT categories, respectively. We validated the model using bootstrap resampling and 10-fold cross-validation, confirming consistent performance. We identified Hct, PaCO2, and PaO2 as significant contributors to model prediction based on the feature importance value. Conclusions: Modern data analysis techniques applied to ABG parameters may guide personalized defibrillation energy selection, particularly in controlled clinical environments such as catheterization laboratories and intensive care units where ABG measurements are readily available.<\/jats:p>","DOI":"10.3390\/jcm14113879","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T10:21:49Z","timestamp":1748859709000},"page":"3879","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting the Higher Energy Need for Effective Defibrillation Using Machine Learning Based on an Animal Model"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8625-4815","authenticated-orcid":false,"given":"\u00c1d\u00e1m","family":"P\u00e1l-Jakab","sequence":"first","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2059-5462","authenticated-orcid":false,"given":"Boldizs\u00e1r","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8334-2385","authenticated-orcid":false,"given":"Bettina","family":"Nagy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivetta","family":"Boldizs\u00e1r","sequence":"additional","affiliation":[{"name":"Data Science, E\u00f6tv\u00f6s Lor\u00e1nd University, 1053 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8209-990X","authenticated-orcid":false,"given":"Istv\u00e1n","family":"Osztheimer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika R\u00f3zsa","family":"D\u00e9v\u00e9nyin\u00e9","sequence":"additional","affiliation":[{"name":"Innomed Medical\u2014Medical Developing and Manufacturing Inc., 1146 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violetta","family":"K\u00e9kesi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsolt","family":"L\u00f3r\u00e1nt","sequence":"additional","affiliation":[{"name":"Innomed Medical\u2014Medical Developing and Manufacturing Inc., 1146 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6514-0723","authenticated-orcid":false,"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Endre","family":"Zima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Semmelweis University Heart and Vascular Center, 1122 Budapest, Hungary"},{"name":"Institute of Anaesthesiology and Perioperative Patient Care, Semmelweis University, 1096 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1016\/j.jacc.2017.07.778","article-title":"Defibrillation for Ventricular Fibrillation: A Shocking Update","volume":"70","author":"Nichol","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1093\/eurheartj\/ehl199","article-title":"ACC\/AHA\/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death--executive summary: A report of the American College of Cardiology\/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society","volume":"27","author":"Zipes","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Li, W., Li, J., Wei, L., Wang, J., Peng, L., Wang, J., Yin, C., and Li, Y. (2021). A framework of current based defibrillation improves defibrillation efficacy of biphasic truncated exponential waveform in rabbits. Sci. Rep., 11.","DOI":"10.1038\/s41598-020-80521-9"},{"key":"ref_4","first-page":"587","article-title":"Does early defibrillation improve long-term survival and quality of life after cardiac arrest?","volume":"169","author":"Choi","year":"2003","journal-title":"CMAJ"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1001\/jama.289.11.1389","article-title":"Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: A randomized trial","volume":"289","author":"Wik","year":"2003","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1001\/jama.281.13.1182","article-title":"Influence of Cardiopulmonary Resuscitation Prior to Defibrillation in Patients With Out-of-Hospital Ventricular Fibrillation","volume":"281","author":"Cobb","year":"1999","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2250","DOI":"10.1097\/CCM.0b013e31819ffc6a","article-title":"Initial defibrillation versus initial chest compression in a 4-minute ventricular fibrillation canine model of cardiac arrest*","volume":"37","author":"Wang","year":"2009","journal-title":"Crit. Care Med."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Mandigers, L., Boersma, E., den Uil, C.A., Gommers, D., B\u011blohl\u00e1vek, J., Belliato, M., Lorusso, R., and Dos Reis Miranda, D. (2022). Systematic review and meta-analysis comparing low-flow duration of extracorporeal and conventional cardiopulmonary resuscitation. Interact. Cardiovasc. Thorac. Surg., 35.","DOI":"10.1093\/icvts\/ivac219"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Park, I.H., Yang, J.H., Jang, W.J., Chun, W.J., Oh, J.H., Park, Y.H., Yu, C.W., Kim, H.J., Kim, B.S., and Jeong, J.O. (2020). Clinical Significance of Low-Flow Time in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation: Results from the RESCUE Registry. J. Clin. Med., 9.","DOI":"10.3390\/jcm9113588"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.resuscitation.2021.08.033","article-title":"No flow time, bystander low flow time and EMS system response time: Are we looking at two sides of the same coin?","volume":"167","author":"Cheskes","year":"2021","journal-title":"Resuscitation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1097\/CCM.0000000000005594","article-title":"Accuracy of the Initial Rhythm to Predict a Short No-Flow Time in Out-of-Hospital Cardiac Arrest","volume":"50","author":"Cournoyer","year":"2022","journal-title":"Crit. Care Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1556\/650.2023.32717","article-title":"Ritmus- \u00e9s frekvenciakontroll \u00fajra\u00e9leszt\u00e9s kapcs\u00e1n \u00e9s kering\u00e9smeging\u00e1ssal fenyeget\u0151 sz\u00edvritmuszavarok eset\u00e9n","volume":"164","author":"Kiss","year":"2023","journal-title":"Orvosi Hetil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1111\/j.1478-5153.2007.00236.x","article-title":"Nurse-initiated defibrillation? Reality or rhetoric","volume":"12","author":"Dwyer","year":"2007","journal-title":"Nurs. Crit. Care"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1001\/jama.1990.03450080105041","article-title":"Defibrillator failures. Causes of problems and recommendations for improvement. Defibrillator Working Group","volume":"264","author":"Cummins","year":"1990","journal-title":"JAMA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1002\/j.0022-0337.2003.67.12.tb03729.x","article-title":"Automated External Defibrillator Use Among the General Population","volume":"67","author":"Roccia","year":"2003","journal-title":"J. Dent. Educ."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Delgado, H., Toquero, J., Mitroi, C., Castro, V., and Fernandez, I. (2013). Principles of External Defibrillators, InTech.","DOI":"10.5772\/52512"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Pal-Jakab, A., Nagy, B., Kiss, B., and Zima, E. (2023). The Influence of Transthoracic Impedance on Electrical Cardioversion and Defibrillation: Current Data, IntechOpen.","DOI":"10.5772\/intechopen.112538"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"24d","DOI":"10.1016\/S0002-9149(98)00966-7","article-title":"Energy levels for defibrillation: What is of real clinical importance?","volume":"83","author":"Fotuhi","year":"1999","journal-title":"Am. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.hrthm.2006.01.027","article-title":"Benefit of millisecond waveform durations for patients with high defibrillation thresholds","volume":"3","author":"Denman","year":"2006","journal-title":"Heart Rhythm."},{"key":"ref_20","first-page":"21","article-title":"High defibrillation threshold: The science, signs and solutions","volume":"10","author":"Jacob","year":"2010","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.resuscitation.2021.02.010","article-title":"European Resuscitation Council Guidelines 2021: Adult advanced life support","volume":"161","author":"Soar","year":"2021","journal-title":"Resuscitation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/j.1476-4431.2008.00324.x","article-title":"The efficacy and safety of external biphasic defibrillation in toy breed dogs","volume":"18","author":"Lee","year":"2008","journal-title":"J. Vet. Emerg. Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.ccl.2014.01.003","article-title":"Is defibrillation testing necessary?","volume":"32","author":"Russo","year":"2014","journal-title":"Cardiol. Clin."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1111\/pace.12039","article-title":"Predictors of high defibrillation threshold in the modern era","volume":"36","author":"Lin","year":"2013","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.19102\/icrm.2017.081203","article-title":"Predictors of Elevated Defibrillation Threshold with the Subcutaneous Implantable Cardioverter-defibrillator","volume":"8","author":"Do","year":"2017","journal-title":"J. Innov. Card. Rhythm. Manag."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1016\/0735-1097(95)00093-J","article-title":"Clinical predictors of the defibrillation threshold with the unipolar implantable defibrillation system","volume":"25","author":"Raitt","year":"1995","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1161\/01.CIR.86.4.1206","article-title":"Clinical characteristics and outcome of patients with high defibrillation thresholds. A multicenter study","volume":"86","author":"Epstein","year":"1992","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Nagy, B., P\u00e1l-Jakab, \u00c1., Kiss, B., Orb\u00e1n, G., S\u00e9lley, T.L., Dabasi-Hal\u00e1sz, Z., M\u00f3ka, B.B., Gell\u00e9r, L., Merkely, B., and Zima, E. (2023). Remote Management of Patients with Cardiac Implantable Electronic Devices during the COVID-19 Pandemic. J. Cardiovasc. Dev. Dis., 10.","DOI":"10.3390\/jcdd10050214"},{"key":"ref_29","unstructured":"Loizides, F., and Schmidt, B. (2016). Jupyter Notebooks\u2014A publishing format for reproducible computational workflows. Positioning and Power in Academic Publishing: Players, Agents and Agendas, IOS Press."},{"key":"ref_30","first-page":"1","article-title":"Imbalanced-learn: A Python Toolbox to Tackle the Curse of Imbalanced Datasets in Machine Learning","volume":"18","author":"Nogueira","year":"2017","journal-title":"J. Mach. Learn. Res. Microtome Publ."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/s41586-020-2649-2","article-title":"Array programming with NumPy","volume":"Volume 585","author":"Harris","year":"2020","journal-title":"Nature"},{"key":"ref_32","unstructured":"McKinney, W. (July, January 28). Data Structures for Statistical Computing in Python. Proceedings of the 9th Python in Science Conference, Austin, TX, USA."},{"key":"ref_33","first-page":"2825","article-title":"Scikit-learn: Machine Learning in Python","volume":"12","author":"Pedregosa","year":"2011","journal-title":"J. Mach. Learn. Res."},{"key":"ref_34","unstructured":"Jones, E., Oliphant, T., and Peterson, P. (2001). SciPy: Open Source Scientific Tools for Python, Bibsonomy."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Waskom, M. (2021). Seaborn: Statistical Data Visualization. J. Open Source Softw., 6.","DOI":"10.21105\/joss.03021"},{"key":"ref_36","unstructured":"Seabold, S., and Perktold, J. (July, January 28). Statsmodels: Econometric and Statistical Modeling with Python. Proceedings of the 9th Python in Science Conference, Austin, TX, USA."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"874","DOI":"10.1177\/0013164418817803","article-title":"Evaluation of Variance Inflation Factors in Regression Models Using Latent Variable Modeling Methods","volume":"79","author":"Marcoulides","year":"2019","journal-title":"Educ. Psychol. Meas."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"558","DOI":"10.4097\/kja.19087","article-title":"Multicollinearity and misleading statistical results","volume":"72","author":"Kim","year":"2019","journal-title":"Korean J. Anesthesiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s12874-021-01347-1","article-title":"Machine learning in medicine: A practical introduction to natural language processing","volume":"21","author":"Harrison","year":"2021","journal-title":"BMC Med. Res. Methodol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1161\/CIRCULATIONAHA.118.031734","article-title":"From Machine Learning to Artificial Intelligence Applications in Cardiac Care: Real-World Examples in Improving Imaging and Patient Access","volume":"138","author":"Tsay","year":"2018","journal-title":"Circulation"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Chen, T., and Guestrin, C. (2016, January 13\u201317). XGBoost: A Scalable Tree Boosting System. Proceedings of the 22nd ACM Sigkdd International Conference on Knowledge Discovery and Data Mining, San Francisco, CA, USA.","DOI":"10.1145\/2939672.2939785"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Breiman, L., Friedman, J.H., Olshen, R.A., and Stone, C.J. (2017). Classification and Regression Trees, Routledge.","DOI":"10.1201\/9781315139470"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1023\/A:1010933404324","article-title":"Random Forests","volume":"45","author":"Breiman","year":"2001","journal-title":"Mach. Learn."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1109\/34.709601","article-title":"The random subspace method for constructing decision forests","volume":"20","year":"1998","journal-title":"IEEE Trans. Pattern Anal. Mach. Intell."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s10994-006-6226-1","article-title":"Extremely randomized trees","volume":"63","author":"Geurts","year":"2006","journal-title":"Mach. Learn."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1007\/BF00994018","article-title":"Support-vector networks","volume":"20","author":"Cortes","year":"1995","journal-title":"Mach. Learn."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Nematzadeh, S., Kiani, F., Torkamanian-Afshar, M., and Aydin, N. (2022). Tuning hyperparameters of machine learning algorithms and deep neural networks using metaheuristics: A bioinformatics study on biomedical and biological cases. Comput. Biol. Chem., 97.","DOI":"10.1016\/j.compbiolchem.2021.107619"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1161\/01.RES.63.1.147","article-title":"Extracellular field required for excitation in three-dimensional anisotropic canine myocardium","volume":"63","author":"Frazier","year":"1988","journal-title":"Circ. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1161\/CIRCULATIONAHA.106.644765","article-title":"Human ventricular fibrillation: Wandering wavelets, mother rotors, or both?","volume":"114","author":"Ideker","year":"2006","journal-title":"Circulation"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/0735-1097(93)90066-A","article-title":"Successful implantation of cardioverter-defibrillator systems in patients with elevated defibrillation thresholds","volume":"22","author":"Brooks","year":"1993","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1016\/0735-1097(93)90766-T","article-title":"Determinants of successful nonthoracotomy cardioverter-defibrillator implantation: Experience in 101 patients using two different lead systems","volume":"22","author":"Brooks","year":"1993","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1632","DOI":"10.1016\/0735-1097(93)90379-F","article-title":"Predictors of defibrillation efficacy in patients undergoing epicardial defibrillator implantation. The Multicenter Pacemaker-Cardioverter-Defibrillator (PCD) Investigators Group","volume":"21","author":"Leitch","year":"1993","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1540-8167.2006.00352.x","article-title":"The effect of induction method on defibrillation threshold and ventricular fibrillation cycle length","volume":"17","author":"Zima","year":"2006","journal-title":"J. Cardiovasc. Electrophysiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3879\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:44:25Z","timestamp":1760031865000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/11\/3879"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,30]]},"references-count":53,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jcm14113879"],"URL":"https:\/\/doi.org\/10.3390\/jcm14113879","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,5,30]]}}}