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一种基于深度学习的多模态融合模型用于持续性房颤患者复发预测

A Deep Learning-Based Multimodal Fusion Model for Recurrence Prediction in Persistent Atrial Fibrillation Patients.

作者信息

Chen Li, Feng Xujian, Chen Haonan, Tang Biqi, Fang Quan, Chen Taibo, Yang Cuiwei

机构信息

Department of Biomedical Engineering, Fudan University, Shanghai, China.

Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

J Cardiovasc Electrophysiol. 2025 Aug;36(8):1785-1797. doi: 10.1111/jce.16733. Epub 2025 May 23.

Abstract

BACKGROUND

The long-term success rate of atrial fibrillation (AF) ablation remains a significant clinical challenge, particularly in patients with persistent atrial fibrillation (Persistent AF, PeAF). The recurrence risk in PeAF patients is influenced by various factors, which complicates the prediction of ablation outcomes. While clinical characteristics provide important references for risk assessment, the predictive accuracy of existing methods is limited and they fail to fully leverage the rich information contained in electrocardiogram (ECG) signals. Integrating clinical features with ECG signals holds promise for enhancing recurrence prediction accuracy and supporting personalized management.

METHODS

This study conducted a retrospective analysis of PeAF patients who underwent radiofrequency catheter ablation treatment between 2016 and 2019. A multimodal fusion framework based on a residual block network structure was proposed, integrating preprocedural AF rhythm 12-lead ECG signals, clinical scores, and baseline characteristics of the patients to construct a deep learning model for predicting the risk of postablation recurrence in PeAF patients. A fivefold cross-validation method was used to partition the data set for model training and testing.

RESULTS

The fusion model was evaluated on a cohort of 77 PeAF patients, achieving good predictive performance with an average AUC of 0.74, and a maximum of 0.82. It significantly outperformed traditional clinical scoring systems and single-modal models based solely on ECG signals. Additionally, the model demonstrated lower variance (0.08), reflecting its robustness and stability with small sample sizes.

CONCLUSION

This study innovatively combines AF rhythm ECG signals with clinical characteristics to construct a deep learning model for predicting the recurrence risk in PeAF patients after radiofrequency catheter ablation. The results show that this method effectively improves prediction performance and provides support for personalized clinical decision-making, with significant potential for clinical application.

摘要

背景

心房颤动(AF)消融的长期成功率仍然是一项重大的临床挑战,尤其是在持续性心房颤动(持续性房颤,PeAF)患者中。PeAF患者的复发风险受多种因素影响,这使得消融结果的预测变得复杂。虽然临床特征为风险评估提供了重要参考,但现有方法的预测准确性有限,且未能充分利用心电图(ECG)信号中包含的丰富信息。将临床特征与ECG信号相结合有望提高复发预测准确性并支持个性化管理。

方法

本研究对2016年至2019年间接受射频导管消融治疗的PeAF患者进行了回顾性分析。提出了一种基于残差块网络结构的多模态融合框架,整合术前房颤节律12导联ECG信号、临床评分和患者的基线特征,构建用于预测PeAF患者消融后复发风险的深度学习模型。采用五折交叉验证方法对数据集进行划分以进行模型训练和测试。

结果

在一组77例PeAF患者中对融合模型进行了评估,其平均AUC为0.74,最高为0.82,具有良好的预测性能。它显著优于传统临床评分系统和仅基于ECG信号的单模态模型。此外,该模型的方差较低(0.08),反映了其在小样本量情况下的稳健性和稳定性。

结论

本研究创新性地将房颤节律ECG信号与临床特征相结合,构建了用于预测PeAF患者射频导管消融后复发风险的深度学习模型。结果表明,该方法有效提高了预测性能,为个性化临床决策提供了支持,具有显著的临床应用潜力。

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