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Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.

使用基于心电图的深度学习预测应激相关心房颤动后的复发和结局。

期刊: J Am Heart Assoc 日期: 2026-03-20 PMID: 41859908 DOI: 10.1161/JAHA.125.047146 浏览: 76
作者: Julian S Haimovich, Samuel Friedman, Christopher Reeder, Valentina Dsouza, Thomas Sommers, Keisuke Usuda, Shinwan Kany, Emelia J Benjamin, Steven A Lubitz, Mahnaz Maddah, Patrick T Ellinor, Shaan Khurshid
Haimovich, J.S., Friedman, S., Reeder, C., Dsouza, V., Sommers, T., Usuda, K., Kany, S., Benjamin, E.J., Lubitz, S.A., Maddah, M., Ellinor, P.T., & Khurshid, S. (2026). Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.. J Am Heart Assoc. https://doi.org/10.1161/JAHA.125.047146
Haimovich JS, Friedman S, Reeder C, Dsouza V, Sommers T, Usuda K, et al. Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.. J Am Heart Assoc. 2026; doi: 10.1161/JAHA.125.047146
Haimovich JS, Friedman S, Reeder C, et al. Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.[J]. J Am Heart Assoc. 2026. DOI: 10.1161/JAHA.125.047146.
@article{haimovich2026,
  author = {Julian S Haimovich and Samuel Friedman and Christopher Reeder and Valentina Dsouza and Thomas Sommers and Keisuke Usuda and Shinwan Kany and Emelia J Benjamin and Steven A Lubitz and Mahnaz Maddah and Patrick T Ellinor and Shaan Khurshid},
  title = {Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.},
  journal = {J Am Heart Assoc},
  year = {2026},
  doi = {10.1161/JAHA.125.047146},
  note = {PMID: 41859908},
}
TY  - JOUR
AU  - Julian S Haimovich
AU  - Samuel Friedman
AU  - Christopher Reeder
AU  - Valentina Dsouza
AU  - Thomas Sommers
AU  - Keisuke Usuda
AU  - Shinwan Kany
AU  - Emelia J Benjamin
AU  - Steven A Lubitz
AU  - Mahnaz Maddah
AU  - Patrick T Ellinor
AU  - Shaan Khurshid
TI  - Predicting Recurrence and Outcomes After Stressor-Associated Atrial Fibrillation Using ECG-Based Deep Learning.
T2  - J Am Heart Assoc
PY  - 2026
DO  - 10.1161/JAHA.125.047146
AN  - PMID:41859908
ER  - 

摘要

Stressor-associated atrial fibrillation (AF) refers to new-onset AF that occurs with a reversible, acute stressor. Identifying individuals at highest risk for AF recurrence is essential to guide management. Although clinical factors have shown limited value, the utility of contemporary artificial intelligence (AI)-enabled models using the 12-lead ECG to estimate recurrence risk remains unknown. We retrospectively analyzed consecutive primary care and cardiology patients with stressor-associated AF occurring during hospitalization. We quantified the cumulative incidence of recurrence accounting for death as a competing risk. We investigated the relationship between time-varying recurrence and a composite end point of AF-related adverse events (stroke, heart failure, all-cause death) using Cox models. We then developed and validated a penalized regression model to predict recurrence using clinical factors, stressor type, and AF risk estimates from a previously validated ECG-based AI model. We analyzed 3371 patients with stressor-associated AF (mean age, 69±12 years; 40% women). Over a median of 3.7 years (interquartile range, 1.8-7.2), the 10-year cumulative incidence of AF recurrence was 41% (95% CI, 39-44). AF recurrence was strongly associated with AF-related adverse events (hazard ratio, 2.24 [95% CI, 1.81-2.76]). A model incorporating clinical factors, stressor type, and ECG-based AI model AF risk estimates (clinical-AI) discriminated AF recurrence (area under the receiver operating characteristic curve, 0.768 [95% CI, 0.707-0.830]) favorably compared with clinical features (area under the receiver operating characteristic curve, 0.707 [95% CI, 0.642-0.772]; AF recurrence rates following stressor-associated AF are considerable and are associated with substantially higher risk of adverse cardiovascular events. Models incorporating ECG-based AI risk estimates may prioritize individuals for intensive monitoring and preventive interventions.

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