| Autor: |
Arunashis Sau, Safi Ibrahim, Amar Ahmed, Balvinder Handa, Daniel B Kramer, Jonathan W Waks, Ahran D Arnold, James P Howard, Norman Qureshi, Michael Koa-Wing, Daniel Keene, Louisa Malcolme-Lawes, David C Lefroy, Nicholas W F Linton, Phang Boon Lim, Amanda Varnava, Zachary I Whinnett, Prapa Kanagaratnam, Danilo Mandic, Nicholas S Peters, Fu Siong Ng |
| Rok vydání: |
2022 |
| Popis: |
Aims Accurately determining atrial arrhythmia mechanisms from a 12-lead electrocardiogram (ECG) can be challenging. Given the high success rate of cavotricuspid isthmus (CTI) ablation, identification of CTI-dependent typical atrial flutter (AFL) is important for treatment decisions and procedure planning. We sought to train a convolutional neural network (CNN) to classify CTI-dependent AFL vs. non-CTI dependent atrial tachycardia (AT), using data from the invasive electrophysiology (EP) study as the gold standard. Methods and results We trained a CNN on data from 231 patients undergoing EP studies for atrial tachyarrhythmia. A total of 13 500 five-second 12-lead ECG segments were used for training. Each case was labelled CTI-dependent AFL or non-CTI-dependent AT based on the findings of the EP study. The model performance was evaluated against a test set of 57 patients. A survey of electrophysiologists in Europe was undertaken on the same 57 ECGs. The model had an accuracy of 86% (95% CI 0.77–0.95) compared to median expert electrophysiologist accuracy of 79% (range 70–84%). In the two thirds of test set cases (38/57) where both the model and electrophysiologist consensus were in agreement, the prediction accuracy was 100%. Saliency mapping demonstrated atrial activation was the most important segment of the ECG for determining model output. Conclusion We describe the first CNN trained to differentiate CTI-dependent AFL from other AT using the ECG. Our model matched and complemented expert electrophysiologist performance. Automated artificial intelligence-enhanced ECG analysis could help guide treatment decisions and plan ablation procedures for patients with organized atrial arrhythmias. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
