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基于人工智能的 2 小时动态心电图监测在室性和室上性早搏检测中的诊断效率。

The diagnostic efficiency of artificial intelligence based 2 hours Holter monitoring in premature ventricular and supraventricular contractions detection.

机构信息

Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

Department of Cardiac Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.

出版信息

Clin Cardiol. 2024 Apr;47(4):e24266. doi: 10.1002/clc.24266.

Abstract

BACKGROUND

Electrocardiography (ECG) and 24 hours Holter monitoring (24 h-Holter) provided valuable information for premature ventricular and supraventricular contractions (PVC and PSVC). Currently, artificial intelligence (AI) based 2 hours single-lead Holter (2 h-Holter) monitoring may provide an improved strategy for PSVC/PVC diagnosis.

HYPOTHESIS

AI combined with single-lead Holter monitoring improves PSVC/PVC detection.

METHODS

In total, 170 patients were enrolled between August 2022 and 2023. All patients wore both devices simultaneously; then, we compared diagnostic efficiency, including the sensitivity/specificity/positive predictive-value (PPV) and negative predictive-value (NPV) in detecting PSVC/PVC by 24 h-Holter and 2 h-Holter.

RESULTS

The PPV and NPV in patients underwent 2 h-Holter were 76.00%/87.50% and 96.35%/98.55, respectively, and the sensitivity and specificity were 79.17%/91.30%, and 95.65%/97.84% in PSVC/PVC detection compared with 24 h-Holter. The areas under the ROC curves (AUCs) for PSVC and PVC were 0.885 and 0.741, respectively (p < .0001).

CONCLUSIONS

The potential advantages of the 2 h-Holter were shortened wearing period, improved convenience, and excellent consistency of diagnosis.

摘要

背景

心电图(ECG)和 24 小时动态心电图监测(24 h-Holter)为室性和室上性早搏(PVC 和 PSVC)提供了有价值的信息。目前,基于人工智能(AI)的 2 小时单导联动态心电图监测(2 h-Holter)可能为 PSVC/PVC 诊断提供一种改进策略。

假说

AI 与单导联动态心电图监测相结合可提高 PSVC/PVC 的检出率。

方法

2022 年 8 月至 2023 年期间共纳入 170 例患者。所有患者同时佩戴两种设备;然后,我们比较了 24 h-Holter 和 2 h-Holter 检测 PSVC/PVC 的诊断效率,包括敏感性/特异性/阳性预测值(PPV)和阴性预测值(NPV)。

结果

2 h-Holter 组的 PPV 和 NPV 分别为 76.00%/87.50%和 96.35%/98.55%,其在 PSVC/PVC 检测中的敏感性和特异性分别为 79.17%/91.30%和 95.65%/97.84%,均优于 24 h-Holter。PSVC 和 PVC 的 ROC 曲线下面积(AUC)分别为 0.885 和 0.741(p<0.0001)。

结论

2 h-Holter 的潜在优势在于佩戴时间缩短、便利性提高和诊断一致性良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38ca/11000269/0a5417a58c7f/CLC-47-e24266-g002.jpg

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