Q95149128
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Úvod: Cílem této studie je vyhodnocení výkonu nově vyvinutého rytmového modelu určeného pro interpretaci EKG a založeného na umělé inteligenci (AI-ECGRM) v binární klasifikaci mezi sinusovým rytmem a arytmiemi. Metody: Interpretace EKG záznamů generované pomocí AI-ECGRM byly v rámci studie porovnány s diagnostickými závěry zkušeného kardiologa. Metodou použitou ke klasifikaci dat byla matice záměn, přičemž vyhodnocení zahrnuje senzitivitu, specificitu, pozitivní prediktivní hodnotu a negativní prediktivní hodnotu. Výsledky: Testovací datová sada obsahuje 1 491 náhodně vybraných EKG záznamů (průměrný věk 65 ± 21 let; 54 % žen). Pro danou datovou sadu čítala diagnostika kardiologa 1 271 záznamů se závěrem sinusový rytmus a 220 záznamů se závěrem arytmie. Oproti tomu interpretace generovaná pomocí AI-ECGRM čítala 1 169 záznamů se závěrem sinusový rytmus a 322 záznamů se závěrem arytmie. Senzitivita a specificita AI-ECGRM byla 94 % a 91 %. Pozitivní prediktivní hodnota byla 64 %. Negativní prediktivní hodnota dosáhla 99 %, což značí velmi nízkou pravděpodobnost vynechání potenciální patologie. Závěr: Výsledky ukazují na účinnost nově vyvinutého AI-ECGRM pro rozlišení záznamů se sinusovým rytmem a arytmií. Navíc metoda vykazuje vysokou negativní prediktivní hodnotu blížící se 100 %.
Objective: This study aimed to evaluate the performance of a developed novel AI-based ECG rhythm model (AI-ECGRM) in binary classification between sinus rhythm and arrhythmias. Methods: The interpretations generated by the AI-ECGRM were compared to the diagnostic conclusions made by cardiologists. The confusion matrix was used to verify the AI-ECGRM's sensitivity, specificity, positive predictive value, and negative predictive value. Results: The testing dataset included 1,491 randomly selected ECGs (mean age 65±21 years; 54% female). Out of the testing dataset, the highly advanced cardiologists diagnosed 1,271 ECGs as sinus rhythm and 220 as arrhythmia. The AI-ECGRM labelled 1,169 as sinus rhythm and 322 as arrhythmia out of the same ECGs. The sensitivity and specificity of the model were 94% and 91%, respectively. The positive predictive value was 64%. The negative predictive value was 99%, indicating a very low probability of missing any potential pathology. Conclusion: The results demonstrated the efficacy of the developed AI-ECGRM in accurately discriminating between ECGs exhibiting normal sinus rhythm and those indicating cardiac arrhythmias. Moreover, the AI-ECGRM exhibited an exceptional negative predictive value, approaching 100%.
The impact of atrial fibrillation and atrial tachycardias (AF/AT), and their optimal treatment strategy in PH patients is still being discussed. The goal of this study was to evaluate the effect of AF/AT termination on the hemodynamic parameters in PH patients. We compared patients with pre-capillary pulmonary hypertension (PH group), left ventricular heart failure (LV-HF group), and a Control group. A repeated right heart catheterization was performed during the catheter ablation (CA) procedure. The first measurement was done in arrhythmia, the second after the sinus rhythm (SR) was restored. High frequency atrial stimulation was used to simulate AT in patients without arrhythmia presence at the time of the CA. The variation of pressure parameters in PH patients did not differ significantly from the Controls. There was a significant increase in the right ventricle pressure after the SR restoration in the LV-HF group compared to the Controls and PH group (+4 vs. -2 vs. -3 mmHg, p<0.05). The cardiac index (CI) variation was not significant when compared between the study groups. An increase of the CI after the SR restoration was found in those patients with AF (+0.31 l/min/m2 [IQR 0.18; 0.58]) in contrast to those patients with organized AT/high frequency atrial stimulation ( 0.09 l/min/m2, [IQR - 0.45; 0.19]). This difference was statistically significant (p<0.05). The acute hemodynamic response to arrhythmia termination was not significantly different in the PH patients when compared to the Controls. In contrast to AT/high frequency stimulation, the restoration of SR in AF patients leads to an increased CI, irrespective of the presence or absence of PH.
- MeSH
- fibrilace síní * diagnóza chirurgie etiologie MeSH
- hemodynamika MeSH
- katetrizační ablace * metody MeSH
- lidé MeSH
- plicní hypertenze * diagnóza MeSH
- srdeční selhání * MeSH
- srdeční síně chirurgie MeSH
- tachykardie etiologie chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Atrial fibrillation and atrial tachycardias (AF/AT) have been reported as a common condition in patients with pulmonary hypertension (PH). As yet, limited data exists about the significance of the borderline post-capillary pressure component on the occurrence of AF / AT in patients with isolated pre-capillary PH. We retrospectively studied the prevalence of AF / AT in 333 patients (mean age 61 ± 15 years, 44% males) with pre-capillary idiopathic / familiar pulmonary arterial hypertension, and inoperable chronic thromboembolic pulmonary hypertension. The prevalence of AF / AT was analyzed in different categories of pulmonary artery wedge pressure (PAWP). In the study population overall, the mean PAWP was 10.5 ± 3 mmHg, median of 11 mmHg, range 2-15 mmHg. AF / AT was diagnosed in 79 patients (24%). The proportion of AF / AT among patients with PAWP below the median (?11 mmHg) was lower than in subjects with PAWP between 12 and 15 mmHg, 30 (16%) vs. 46 (35%), p = 0.0001. Compared to the patients with PAWP?11 mmHg, subjects with PAWP between 12 and 15 mmHg were older (65 ± 13 years vs. 58 ± 16), with more prevalent arterial hyperte\nsion [100 (70%) vs. 106 (55%)] and diabetes mellitus [50 (35%) vs. 48 (25%)], showed larger size of the left atrium (42 ± 7 vs. 40 ± 6 mm), and higher values of right atrium pressure (12 ± 5 vs. 8 ± 5 mm Hg), p < 0.05 in all comparisons. The prevalence of AF / AT in the group studied increased with the growing post-capillary component.
- MeSH
- dospělí MeSH
- fibrilace síní epidemiologie etiologie MeSH
- incidence MeSH
- lidé středního věku MeSH
- lidé MeSH
- plicní hypertenze komplikace patofyziologie MeSH
- plicní tlak v zaklínění * MeSH
- prevalence MeSH
- registrace * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- síňová ektopická tachykardie epidemiologie etiologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
