AUTHOR=Zhang Haqi , Pan Xiaotian , Zhou Shan , Zhang Weiwei , Chen Jing , Pan Limin TITLE=Advanced ECG feature extraction and SVM classification for predicting defibrillation success in OHCA JOURNAL=Frontiers in Cardiovascular Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1550422 DOI=10.3389/fcvm.2025.1550422 ISSN=2297-055X ABSTRACT=Out-of-hospital cardiac arrest (OHCA) represents a critical challenge for emergency medical services, with the necessity for rapid and accurate prediction of defibrillation outcomes to enhance patient survival. This study leverages a dataset of 251 ECG signals from OHCA patients, consisting of 195 unsuccessful and 56 successful resuscitation attempts as categorized by expert cardiologists. We extracted six crucial features from each ECG signal: heart rate, QRS complex amplitude, QRS complex duration, total power, low-frequency power (0.04–0.15 Hz), and high-frequency power (0.15–0.4 Hz). These features were derived using standard temporal and frequency domain methods. Subsequent analysis focused on selecting the most predictive features, with QRS complex amplitude, total power, and low-frequency power showing the highest discriminative ability based on their Area Under the Curve (AUC) values. A Support Vector Machine (SVM) classifier, trained on these selected features, demonstrated a prediction accuracy of 95.6%, highlighting the efficacy of combining targeted ECG signal features with machine learning techniques to forecast defibrillation success accurately. This approach provides a non-invasive, rapid, and reliable method to support clinical decisions during OHCA emergencies. Future research aims to expand the dataset, refine feature extraction techniques, and explore additional machine learning models to further enhance prediction accuracy. This study underscores the potential of ECG-based feature analysis and targeted machine learning in improving resuscitation strategies, ultimately contributing to higher survival rates in OHCA patients.