Preimplantation AI-ECG Age as a Predictor of Survival Following Cardiac Resynchronization Therapy

Area of Science:

• Cardiology
• Artificial Intelligence
• Biomedical Engineering

Background:

• Cardiac resynchronization therapy with defibrillator (CRT-D) is not effective for all heart failure patients.
• Artificial intelligence-enabled electrocardiography (AI-ECG) age is a novel marker for biological age.

Purpose of the Study:

• To assess if preimplantation AI-ECG age predicts survival in patients undergoing CRT-D.
• To determine the relationship between AI-ECG age and chronological age (δage) and its impact on patient outcomes.

Main Methods:

• Retrospective review of 464 patients who received CRT-D.
• Calculation of AI-ECG age and chronological age, with δage derived from preimplantation ECGs.
• Survival analysis using multivariable models to identify predictors of all-cause mortality.

Main Results:

• Lower δage (AI-ECG age minus chronological age) correlated with longer survival post-CRT-D.
• Patients with δage < 0 had higher rates of comorbidities.
• A categorical δage >5.1 years was associated with significantly shorter survival.

Conclusions:

• Preimplantation AI-ECG-derived δage is an independent predictor of survival after CRT-D.
• A lower AI-ECG age relative to chronological age suggests better long-term survival, possibly indicating a healthier biologic age.