Portable Device Improves the Detection of Atrial Fibrillation After Ablation
Portable Device Improves the Detection of Atrial Fibrillation After Ablation
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DOI：
10.1536/ihj.21-067
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发表时间：
2021-07-01
影响因子：
1.5
通讯作者：
Cao, Jiang
中科院分区：
文献类型：
--
作者：
Huang, Songqun;Zhao, Teng;Cao, Jiang
心房颤动（AF）消融术后无症状复发已被发现是常见的。一项使用手持式单导联ECG监护仪（BigThumb？）进行AF筛查的随机对照试验或对导管消融术后的非瓣膜性房颤患者进行传统随访策略。将符合条件的患者随机分为大拇指组（BT组）和传统随访组（TF组）。使用自动AF检测算法、人工智能（AI）算法和心脏病专家的手动审查对通过BigThumb收集的ECG进行比较。还记录了患者口服抗凝剂依从性的后续变化。在这项研究中，我们检查了218例患者（每组109例）。随访345.4 ± 60.2天后，BT组和TF组的无AF生存率分别为64.2%和78.9%（P = 0.0163），BT组对口服抗凝剂的依从性更高（P = 0.0052）。BT组参与者记录了26133例ECG，其中3299例（12.6%）被心脏病专家手动复查诊断为AF。AI算法的敏感性和特异性分别为94.4%和98.5%，显著高于自动AF检测算法（90.7%和96.2%）。根据我们的研究结果，确定使用BigThumb进行AF消融术后的随访导致更频繁地检测到AF复发，并且更坚持口服抗凝剂。人工智能算法提高了心电图诊断的准确性，并有可能减少人工审查。(Int Heart J 2021; 62：786-791）上标/下标可用
Asymptomatic recurrences of atrial fibrillation (AF) have been found to be common after ablation. A randomized controlled trial of AF screening using a handheld single-lead ECG monitor (BigThumb?) or a traditional follow-up strategy was conducted in patients with non-valvular AF after catheter ablation. Consecu-tive patients were randomized to either BigThumb Group (BT Group) or Traditional Follow-up Group (TF Group). The ECGs collected via BigThumb were compared using the automated AF detection algorithm, artifi-cial intelligence (AI) algorithm, and cardiologists' manual review. Subsequent changes in adherence to oral anti-coagulation of patients were also recorded. In this study, we examined 218 patients (109 in each group). After a follow-up of 345.4 +/- 60.2 days, AF-free survival rate was 64.2% in BT Group and 78.9% in TF Group (P = 0.0163), with more adherence to oral anticoagulation in BT Group (P = 0.0052). The participants in the BT Group recorded 26133 ECGs, among which 3299 (12.6%) were diagnosed as AF by cardiologists' manual re-view. The sensitivity and specificity of the AI algorithm were 94.4% and 98.5% respectively, which are signifi-cantly higher than the automated AF detection algorithm (90.7% and 96.2%). As per our findings, it was determined that follow-up after AF ablation using BigThumb leads to a more frequent detection of AF recurrence and more adherence to oral anticoagulation. AI algorithm improves the ac-curacy of ECG diagnosis and has the potential to reduce the manual review. (Int Heart J 2021; 62: 786-791)Superscript/Subscript Available