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KMID : 1011920200210010019
International Journal of Arrhythmia
2020 Volume.21 No. 1 p.19 ~ p.19
A deep learning model to predict recurrence of atrial fibrillation after pulmonary vein isolation
Kim Ju-Youn

Kim Young-Hoon
Oh Gil-Hwan
Kim Sun-Hwa
Choi Young
Hwang You-Mi
Kim Tae-Seok
Kim Sung-Hwan
Kim Ji-Hoon
Jang Sung-Won
Oh Yong-Seog
Lee Man-Young
Abstract
Background and Objectives: The efficacy of radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) is well established. The standard approach to RFCA in AF is pulmonary vein isolation (PVI). However, a large proportion of patients experiences recurrence of atrial tachyarrhythmia. The purpose of this study is to find out whether the AI model can assess AF recurrence in patients who underwent PVI.

Materials and methods: This study was a retrospective cohort study that enrolled consecutive patients who underwent catheter ablation for symptomatic, drug-refractory AF and PVI. We developed an AI algorithm to predict recurrence of AF after PVI using patient demographics and three-dimensional (3D) reconstructed left atrium (LA) images.

Results: We included 527 consecutive patients in the study. The overall mean LA diameter was 42.0?¡¾?6.8 mm, and the mean LA volume calculated using 3D reconstructed images was 151.1?¡¾?46.7 ml. During the follow-up period, atrial tachyarrhythmia recurred in 158 patients. The area under the curve (AUC) of the AI model based on a convolutional neural network (including 3D reconstruction images) was 0.61 (95% confidence interval [CI] 0.53?0.74) using the test dataset. The total test accuracy was 66.3% (57.0?75.6), and the sensitivity was 53.3% (34.8?71.9). The specificity was 73.2% (51.8?75.0), and the F1 score was 52.5% 34.5?66.7).

Conclusion: In this study, we developed an AI algorithm to predict recurrence of AF after catheter ablation of PVI using individual reconstructed LA images. This AI model was unable to predict recurrence of AF overwhelmingly; therefore, further large-scale study is needed.
KEYWORD
Left atrium, Atrial fibrillation, Pulmonary vein isolation, Catheter ablation
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