Artificial Intelligence-Enabled Electrocardiography Predicts Future Pacemaker Implantation and Adverse Cardiovascular Events.

Medical advances prolonging life have led to more permanent pacemaker implants. When pacemaker implantation (PMI) is commonly caused by sick sinus syndrome or conduction disorders, predicting PMI is challenging, as patients often experience related symptoms. This study was designed to create a deep...

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Publicado en:Journal of Medical Systems Vol. 48; no. 1; pp. 1 - 12
Autores principales: Hung, Yuan, Lin, Chin, Lin, Chin-Sheng, Lee, Chiao-Chin, Fang, Wen-Hui, Lee, Chia-Cheng, Wang, Chih-Hung, Tsai, Dung-Jang
Formato: research tables/charts Journal Article
Publicado: Springer Nature 7/19/2024
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Artificial Intelligence-Enabled Electrocardiography Predicts Future Pacemaker Implantation and Adverse Cardiovascular Events.
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          Hung, Yuan
          Lin, Chin
          Lin, Chin-Sheng
          Lee, Chiao-Chin
          Fang, Wen-Hui
          Lee, Chia-Cheng
          Wang, Chih-Hung
          Tsai, Dung-Jang
        affil: Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center Taipei, Taipei, Taiwan, R.O.C.
      sug:
        subj:
          Artificial Intelligence
          Electrocardiography
          Major Adverse Cardiac Events Risk Factors
          Pacemaker, Artificial
          Risk Assessment
          Deep Learning
          Prediction Models
          Human
          Male
          Female
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Retrospective Design
          Record Review
          Descriptive Statistics
          ROC Curve
          Sensitivity and Specificity
          Cox Proportional Hazards Model
          Confidence Intervals
          Data Analysis Software
          Funding Source
          Cardiovascular Diseases Mortality
          Heart Rate
          QRS Complex
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Medical advances prolonging life have led to more permanent pacemaker implants. When pacemaker implantation (PMI) is commonly caused by sick sinus syndrome or conduction disorders, predicting PMI is challenging, as patients often experience related symptoms. This study was designed to create a deep learning model (DLM) for predicting future PMI from ECG data and assess its ability to predict future cardiovascular events. In this study, a DLM was trained on a dataset of 158,471 ECGs from 42,903 academic medical center patients, with additional validation involving 25,640 medical center patients and 26,538 community hospital patients. Primary analysis focused on predicting PMI within 90 days, while all-cause mortality, cardiovascular disease (CVD) mortality, and the development of various cardiovascular conditions were addressed with secondary analysis. The study's raw ECG DLM achieved area under the curve (AUC) values of 0.870, 0.878, and 0.883 for PMI prediction within 30, 60, and 90 days, respectively, along with sensitivities exceeding 82.0% and specificities over 81.9% in the internal validation. Significant ECG features included the PR interval, corrected QT interval, heart rate, QRS duration, P-wave axis, T-wave axis, and QRS complex axis. The AI-predicted PMI group had higher risks of PMI after 90 days (hazard ratio [HR]: 7.49, 95% CI: 5.40-10.39), all-cause mortality (HR: 1.91, 95% CI: 1.74–2.10), CVD mortality (HR: 3.53, 95% CI: 2.73–4.57), and new-onset adverse cardiovascular events. External validation confirmed the model's accuracy. Through ECG analyses, our AI DLM can alert clinicians and patients to the possibility of future PMI and related mortality and cardiovascular risks, aiding in timely patient intervention.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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