机器学习识别了食道光温度模式与热损伤相关的导管切除对于心房的导管切除
Yaacoub Chahine1, Tanzina Afroze1, Savannah F Bifulco2
1Division of Cardiology, University of Washington, Seattle, Washington, USA.
Journal of cardiovascular electrophysiology
|February 15, 2024
概括
在心房动 (AF) 剥离过程中对光线食道温度 (LET) 的监测可以预测食道病变. 温度变化速度和曲线下的面积,而不是峰值温度,是识别患有食道损伤风险的患者的关键指标.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 干预程序 干预程序
背景情况:
- 在心房动 (AF) 废除过程中,对光线食道温度 (LET) 的监测至关重要,以尽量减少食道损伤.
- 尽管目前的监测技术,内镜检测到的食道病变 (EDEL) 仍然令人担忧.
研究的目的:
- 为了研究 AF 剥离过程中与 EDEL 相关的 LET 变化的特定模式.
- 为了确定机器学习是否可以根据LET数据预测EDEL.
主要方法:
- 使用高保真多传感器探针对接受射频切除 (RFA) 或冷热气球切除 (CBA) 的AF患者进行LET记录.
- 使用可解释的机器学习和夏普利添加式解释 (SHAP) 分析用于EDEL预测和特征重要性评估.
主要成果:
- 在RFA中,较高的LET上升率 (0.08°C/s vs. 0.02°C/s) 和较小的峰值温度AUC与EDEL相关.
- 在CBA中,在患有EDEL的患者中观察到更快的LET下降和较小的谷部AUC.
- SHAP分析发现LET速率变化>0.05°C/s和AUC<600可以预测RFA中的EDEL.
结论:
- 温度变化率和温度记录曲线下的面积 (AUC) 是EDEL的重要预测指标.
- 绝对峰值光食道温度不是预测AF切除期间食道病变的可靠指标.
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