Detection of Left Atrial Myopathy Using Artificial Intelligence–Enabled Electrocardiography

Dec 16, 2021Circulation. Heart failure

Using Artificial Intelligence with ECG to Detect Left Atrium Muscle Disease

AI simplified

Abstract

Each 10% increase in AI-probability of atrial fibrillation is associated with a 31% greater risk of developing new-onset atrial fibrillation.

Higher AI-probability of atrial fibrillation correlates with more severe structural heart disease, including greater left ventricular hypertrophy and larger left atrial volumes.
Patients with increased AI-probability exhibit lower left atrial reservoir and booster strain.
Elevated cardiac filling and pulmonary artery pressures are observed in patients with higher AI-probability.
Cardiac output reserve during exercise is more impaired in those with higher AI-probability.
In the overall cohort, each 10% increase in AI-probability is associated with a 12% greater risk of death during long-term follow-up, although this finding lost significance after adjustments.

AI simplified

BACKGROUND: Left atrial (LA) myopathy is common in patients with heart failure and preserved ejection fraction and leads to the development of atrial fibrillation (AF). We investigated whether the likelihood of LA remodeling, LA dysfunction, altered hemodynamics, and risk for incident AF could be identified from a single 12-lead ECG using a novel artificial intelligence (AI)-enabled ECG analysis.

METHODS: Patients with heart failure and preserved ejection fraction (n=613) underwent AI-enabled ECG analysis, echocardiography, and cardiac catheterization. Individuals were grouped by AI-enabled ECG probability of contemporaneous AF, taken as an indicator of underlying LA myopathy.

RESULTS: Structural heart disease was more severe in patients with higher AI-probability of AF, with more left ventricular hypertrophy, larger LA volumes, and lower LA reservoir and booster strain. Cardiac filling pressures and pulmonary artery pressures were higher in patients with higher AI-probability, while cardiac output reserve was more impaired during exercise. Among patients with sinus rhythm and no prior AF, each 10% increase in AI-probability was associated with a 31% greater risk of developing new-onset AF (hazard ratio, 1.31 [95% CI, 1.20-1.42];<0.001). In the population as a whole, each 10% increase in AI-probability was associated with a 12% greater risk of death (hazard ratio, 1.12 [95% CI, 1.08-1.17];<0.001) during long-term follow-up, which was no longer significant after adjustments for baseline characteristics. P P

CONCLUSIONS: A novel AI-enabled score derived from a single 12-lead ECG identifies the presence of underlying LA myopathy in patients with heart failure and preserved ejection fraction as evidenced by structural, functional, and hemodynamic abnormalities, as well as long-term risk for incident AF. Further research is required to determine the role of the AI-enabled ECG in the evaluation and care of patients with heart failure and preserved ejection fraction.

Full Text

Full text is available at the source.

View full text ↗

Abstract

Full Text

what lands in your inbox each week: