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Intelligent Algorithm-Based Electrocardiography to Predict Atrial Fibrillation after Coronary Artery Bypass Grafting
1Department of Cardiovascular Medicine, Zhongshan People's Hospital, Zhongshan 528400, China.
Insights
This study found that the Gentle AdaBoost algorithm accurately predicts atrial fibrillation (AF) after coronary artery bypass grafting (CABG) in elderly patients. Pmax and Pmin, derived from ECGs, are key indicators for identifying AF post-CABG.
Area of Science:
- Cardiology
- Medical Informatics
- Artificial Intelligence in Medicine
Background:
- Atrial fibrillation (AF) is a common complication after coronary artery bypass grafting (CABG).
- Early detection of postoperative AF is crucial for managing elderly patients undergoing CABG.
- Predictive value of electrocardiogram (ECG) parameters for AF post-CABG requires further investigation.
Purpose of the Study:
- To evaluate the predictive capability of an intelligent analysis algorithm using ECG for AF in elderly patients post-CABG.
- To compare the performance of the Gentle AdaBoost algorithm with the back-propagation algorithm for AF detection.
- To identify specific ECG parameters (Pmax, Pmin) predictive of AF after CABG.
Main Methods:
- Selected 106 elderly patients (52 with AF, 54 controls) undergoing CABG.
- Utilized a dynamic ECG monitoring system with the Gentle AdaBoost algorithm post-operation.
- Measured 12-lead P wave duration, maximum P wave duration (Pmax), and minimum P wave duration (Pmin).
Main Results:
- The Gentle AdaBoost algorithm achieved 93.7% accuracy, outperforming the back-propagation algorithm by 16.1%.
- Pmax and Pmin were significantly associated with AF post-CABG (P < 0.05).
- Pmax and Pmin demonstrated good sensitivity and specificity in predicting paroxysmal AF.
Conclusions:
- The Gentle AdaBoost algorithm exhibits superior generalization ability and arrhythmia identification compared to the back-propagation algorithm.
- Pmax and Pmin are significant indicators for predicting AF in elderly patients following CABG.
- Intelligent ECG analysis holds promise for early AF detection in high-risk surgical patients.
Abstract:
The objective of this study was to explore the predictive value of electrocardiogram (ECG) based on intelligent analysis algorithm for atrial fibrillation (AF) in elderly patients undergoing coronary artery bypass grafting (CABG). Specifically, 106 elderly patients with coronary heart disease who underwent CABG in the hospital were selected, including 52 patients with postoperative AF (AF group) and 54 patients without arrhythmia (control group). Within 1-3 weeks after operation, the dynamic ECG monitoring system based on Gentle AdaBoost algorithm constructed in this study was adopted. After the measurement of the 12-lead P wave duration, the maximum P wave duration (Pmax) and minimum P wave duration (Pmin) were recorded. As for simulation experiments, the same data was used as the back-propagation algorithm. The results showed that for the detection accuracy of the test samples, the Gentle AdaBoost algorithm showed 93.7% accuracy after the first iteration, and the Gentle AdaBoost algorithm was 16.1% higher than the back-propagation algorithm. Compared with the control group, the detection rate of arrhythmia in patients after CABG was significantly lower (P < 0.05). Bivariate logistic regression analysis on Pmax and Pmin showed as follows: Pmax: 95% confidential interval (CI): 1.024-1.081, P < 0.05; Pmin: 95% CI: 1.036-1.117, P < 0.05. The sensitivity of Pmax and Pmin in predicting paroxysmal AF was 78.2% and 73.4%, respectively; the specificity of them was 80.1% and 85.6%, respectively; the positive predictive value was 81.2% and 83.4%, respectively; and the negative predictive value was 79.5% and 75.3%, respectively. In conclusion, the generalization ability of Gentle AdaBoost algorithm was better than that of back-propagation algorithm, and it can identify arrhythmia better. Pmax and Pmin were important indicators of AF after CABG.
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