Key result
MedGemma-Fusion model integrating structured data and clinical text predicts AF recurrence with 0.911 AUC.
Why the study?
Multimodal perioperative data offer valuable insights for stratifying recurrence risk after AF ablation, but remain underutilized in prediction models.
Does a multimodal deep learning model integrating structured data and clinical text improve the prediction of atrial fibrillation recurrence after ablation compared to conventional risk scores?
Observational (n=2,508)
Yes
Does a multimodal deep learning model integrating structured data and clinical text improve the prediction of atrial fibrillation recurrence after ablation compared to conventional risk scores?
Effect estimate: AUC 0.911 (95% CI 0.878-0.941)
A multimodal deep learning model integrating structured clinical data and unstructured medical text (MedGemma-Fusion) accurately predicts atrial fibrillation recurrence after ablation, outperforming traditional clinical risk scores.
Multimodal perioperative data from patients undergoing atrial fibrillation (AF) ablation offer valuable insights for stratifying recurrence risk, yet remain underutilized in prediction models. This multicenter retrospective study included 2508 patients who underwent AF ablation at five Chinese centers: The Fourth Affiliated Hospital of Zhejiang University School of Medicine (Jan 2016-Mar 2024; Training Cohort), Taizhou Hospital of Zhejiang Province (Jan 2015-Jan 2024; Training Cohort), The Affiliated Hospital of Yunnan University (Jan 2016-Jan 2024; Validation Cohort), Jinhua People's Hospital (Jan 2020-Jan 2024; Test Cohort), and Ningbo Beilun Hospital (Jan 2020-Jan 2024; Test Cohort). We developed a dual-branch deep learning model to predict AF recurrence, in which structured data were processed via a 1D ResNet and textual data were encoded using four large language models (LLaMA-7B, Phi2-2.7B, Mistral-7B, and MedGemma-27B). The model incorporating MedGemma for text feature extraction performed best, achieving areas under the curve of 0.934 (95% CI: 0.921-0.946), 0.928 (95% CI: 0.904-0.950), and 0.911 (95% CI: 0.878-0.941) on the training, validation, and test sets, respectively. Our model integrates multimodal perioperative data from AF ablation patients, effectively identifies high-risk individuals, and may facilitate targeted interventions to reduce relapse.
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Jia et al. (2026) conducted an observational in Atrial fibrillation (n=2,508). MedGemma-Fusion deep learning model vs. Conventional clinical risk scores (CHA2DS2-VASc, CAAP-AF, APPLE) was evaluated on Prediction of atrial fibrillation recurrence (AUC on test set) (AUC 0.911, 95% CI 0.878-0.941). The MedGemma-Fusion deep learning model integrating structured data and clinical text predicted atrial fibrillation recurrence with an area under the curve of 0.911 on the test set.
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