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人工智能在检测和预测导管消融术后房性心律失常中的应用

The Use of Artificial Intelligence for Detecting and Predicting Atrial Arrhythmias Post Catheter Ablation.

作者信息

Lallah Poojesh Nikhil, Laite Chen, Bangash Abdul Basit, Chooah Outesh, Jiang Chenyang

机构信息

Department of Cardiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016 Hangzhou, Zhejiang, China.

Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 310016 Hangzhou, Zhejiang, China.

出版信息

Rev Cardiovasc Med. 2023 Jul 31;24(8):215. doi: 10.31083/j.rcm2408215. eCollection 2023 Aug.

Abstract

Catheter ablation (CA) is considered as one of the most effective methods technique for eradicating persistent and abnormal cardiac arrhythmias. Nevertheless, in some cases, these arrhythmias are not treated properly, resulting in their recurrences. If left untreated, they may result in complications such as strokes, heart failure, or death. Until recently, the primary techniques for diagnosing recurrent arrhythmias following CA were the findings predisposing to the changes caused by the arrhythmias on cardiac imaging and electrocardiograms during follow-up visits, or if patients reported having palpitations or chest discomfort after the ablation. However, these follow-ups may be time-consuming and costly, and they may not always determine the root cause of the recurrences. With the introduction of artificial intelligence (AI), these follow-up visits can be effectively shortened, and improved methods for predicting the likelihood of recurring arrhythmias after their ablation procedures can be developed. AI can be divided into two categories: machine learning (ML) and deep learning (DL), the latter of which is a subset of ML. ML and DL models have been used in several studies to demonstrate their ability to predict and identify cardiac arrhythmias using clinical variables, electrophysiological characteristics, and trends extracted from imaging data. AI has proven to be a valuable aid for cardiologists due to its ability to compute massive amounts of data and detect subtle changes in electric signals and cardiac images, which may potentially increase the risk of recurrent arrhythmias after CA. Despite the fact that these studies involving AI have generated promising outcomes comparable to or superior to human intervention, they have primarily focused on atrial fibrillation while atrial flutter (AFL) and atrial tachycardia (AT) were the subjects of relatively few AI studies. Therefore, the aim of this review is to investigate the interaction of AI algorithms, electrophysiological characteristics, imaging data, risk score calculators, and clinical variables in predicting cardiac arrhythmias following an ablation procedure. This review will also discuss the implementation of these algorithms to enable the detection and prediction of AFL and AT recurrences following CA.

摘要

导管消融术(CA)被认为是根除持续性和异常心律失常最有效的方法之一。然而,在某些情况下,这些心律失常未能得到妥善治疗,导致复发。如果不加以治疗,可能会导致中风、心力衰竭或死亡等并发症。直到最近,诊断CA后复发性心律失常的主要技术是在随访期间通过心脏成像和心电图检查心律失常引起的变化,或者患者在消融术后报告有心悸或胸部不适。然而,这些随访可能耗时且成本高昂,而且并不总能确定复发的根本原因。随着人工智能(AI)的引入,可以有效缩短这些随访时间,并开发出改进的方法来预测消融术后心律失常复发的可能性。AI可分为两类:机器学习(ML)和深度学习(DL),后者是ML的一个子集。ML和DL模型已在多项研究中用于证明它们利用临床变量、电生理特征以及从成像数据中提取的趋势来预测和识别心律失常的能力。由于AI能够计算大量数据并检测电信号和心脏图像中的细微变化,这可能会增加CA后心律失常复发的风险,因此已被证明对心脏病专家有很大帮助。尽管这些涉及AI的研究取得了与人类干预相当或更优的有前景的结果,但它们主要集中在心房颤动,而心房扑动(AFL)和房性心动过速(AT)则是相对较少AI研究的对象。因此,本综述的目的是研究AI算法、电生理特征、成像数据、风险评分计算器和临床变量在预测消融术后心律失常方面的相互作用。本综述还将讨论这些算法的实施,以实现对CA后AFL和AT复发的检测和预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5fb/11266764/7112722bdf2f/2153-8174-24-8-215-g1.jpg

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