Chung Cheuk To, Bazoukis George, Lee Sharen, Liu Ying, Liu Tong, Letsas Konstantinos P, Armoundas Antonis A, Tse Gary
Cardiac Electrophysiology Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
Department of Cardiology, Larnaca General Hospital, Larnaca, Cyprus.
Int J Arrhythmia. 2022;23. doi: 10.1186/s42444-022-00062-2. Epub 2022 Apr 1.
Ventricular arrhythmias (VAs) and sudden cardiac death (SCD) are significant adverse events that affect the morbidity and mortality of both the general population and patients with predisposing cardiovascular risk factors. Currently, conventional disease-specific scores are used for risk stratification purposes. However, these risk scores have several limitations, including variations among validation cohorts, the inclusion of a limited number of predictors while omitting important variables, as well as hidden relationships between predictors. Machine learning (ML) techniques are based on algorithms that describe intervariable relationships. Recent studies have implemented ML techniques to construct models for the prediction of fatal VAs. However, the application of ML study findings is limited by the absence of established frameworks for its implementation, in addition to clinicians' unfamiliarity with ML techniques. This review, therefore, aims to provide an accessible and easy-to-understand summary of the existing evidence about the use of ML techniques in the prediction of VAs. Our findings suggest that ML algorithms improve arrhythmic prediction performance in different clinical settings. However, it should be emphasized that prospective studies comparing ML algorithms to conventional risk models are needed while a regulatory framework is required prior to their implementation in clinical practice.
室性心律失常(VAs)和心源性猝死(SCD)是严重的不良事件,会影响普通人群以及具有心血管危险因素的患者的发病率和死亡率。目前,传统的疾病特异性评分用于风险分层。然而,这些风险评分存在一些局限性,包括验证队列之间的差异、纳入的预测因素数量有限而忽略了重要变量,以及预测因素之间的隐藏关系。机器学习(ML)技术基于描述变量间关系的算法。最近的研究已采用ML技术构建预测致命性室性心律失常的模型。然而,除了临床医生对ML技术不熟悉之外,ML研究结果的应用还受到缺乏既定实施框架的限制。因此,本综述旨在提供关于ML技术在室性心律失常预测中应用的现有证据的通俗易懂的总结。我们的研究结果表明,ML算法在不同临床环境中可提高心律失常的预测性能。然而,应该强调的是,需要进行将ML算法与传统风险模型进行比较的前瞻性研究,并且在临床实践中实施之前需要一个监管框架。