| Title: | Artificial intelligence-estimated electrocardiographic sex as a recurrence predictor after atrial fibrillation catheter ablation |
| Journal: | European Heart Journal - Digital Health |
| Published: | 19 May 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40703131/ |
| DOI: | https://doi.org/10.1093/ehjdh/ztaf054 |
| URL: | https://academic.oup.com/ehjdh/advance-article-pdf/doi/10.1093/ehjdh/ztaf054/63228089/ztaf054.pdf |
Publication 15307
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Abstract
Aims: We explored whether artificial intelligence (AI)-enabled electrocardiographic (ECG) sex discrepancy would predict atrial fibrillation (AF) recurrence after catheter ablation for paroxysmal AF.</p>
Methods and results: The AI-ECG sex prediction model was developed from the MIMIC-IV and externally validated on CODE-15% (AUC 0.89) and UK Biobank (AUC 0.92) cohorts. After validation, we estimated AI-ECG sex from pre-procedural sinus rhythm ECGs among paroxysmal AF patients scheduled for catheter ablation using data from a pooled AF ablation cohort (n = 4385) in South Korea. ECG sex discrepancy was defined as ECG sex probability of more than 50% for the opposite sex. During a median follow-up of 24 months, 1094 recurrences developed [median age 60 (52-67) years; women 29.0%]. ECG sex discrepant patients were older, had more heart failure, and had elevated diastolic filling pressure compared with ECG sex non-discrepant patients. The odds ratio (OR) for left atrial enlargement was significantly higher among ECG sex discrepant women [adjusted OR 1.67, 95% confidence interval (CI) 1.14-2.44, P = 0.008] but not among men (adjusted OR 0.88, 95% CI 0.66-1.17, P = 0.368). The 5-year cumulative event rate of AF recurrence was significantly higher among ECG sex discrepant women (log rank, P = 0.015) but not among men (log rank, P = 0.871). The 5-year risk of AF recurrence was significantly higher among ECG sex discrepant women [hazard ratio (HR) 1.42, 95% CI 1.10-1.83, P = 0.007] but not among men (HR 1.01, 95% CI 0.76-1.34, P = 0.940).</p>
Conclusion: Pre-procedural ECG sex discrepancy has a prognostic value for AF recurrence after catheter ablation for paroxysmal AF in women.</p>
13 Authors
- Hanjin Park
- Oh-Seok Kwon
- Jaemin Shim
- Daehoon Kim
- Je-Wook Park
- Yun-Gi Kim
- Hee Tae Yu
- Tae-Hoon Kim
- Jae-Sun Uhm
- Jong-Il Choi
- Boyoung Joung
- Moon-Hyoung Lee
- Hui-Nam Pak
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