在EAST-AFNET 4试验中,对早期节律控制和心血管事件的预计心房动负担
Stef Zeemering1, Katrin Borof2, Ulrich Schotten1,3,4
1Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands.
EClinicalMedicine
|November 3, 2025
概括
以每周心电图测量的心房动 (AF) 负担会影响接受节律控制治疗的患者的心血管结果. 更高的AF负担与事件率的增加相关,这表明它可以完善AF诊断和风险分层.
科学领域:
- 心脏病学 心脏病学
- 人工智能在医学中的应用
- 数字健康数字健康
背景情况:
- 心房动 (AF) 诊断是通过心电图进行的二元诊断,缺乏动态严重性评估.
- AF负担,即AF中的时间比例,影响AF相关的结果风险.
- 在节律控制治疗期间,AF负担对心血管结果的影响尚不清楚.
研究的目的:
- 用AI分类的心电图来估计AF负担,这些患者被随机分配到早期节律控制治疗中.
- 在EAST-AFNET 4试验中调查AF负担和心血管结果之间的关联.
主要方法:
- 由患者操作的遥测心电图 (每周1-2次) 监督的AI分类节奏.
- 在随机化后的第一年估计了AF负担 (12个月的里程碑).
- 在4.1年的有效性和安全性结果在AF负担四分位数中进行了比较.
主要成果:
- 在1178名患者中,第一年AF负担的中位数为6%.
- 较低的AF负担 (Q1-Q2) 显示出较低的事件率 (2.0-2.6事件/100患者年).
- 较高的AF负担 (Q3-Q4) 显示事件发生率增加 (4.2-4.8事件/100患者年),类似于通常的护理.
结论:
- 产生假设的研究结果表明,AF负担估计精确了AF诊断.
- 基于心电图的每周AF负担监测可以预测节律控制期间的心血管事件.
- 需要进一步验证和剩余混性评估.
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