Key result
Preoperative AI-ECG and TTE predict a ~42% absolute gap in AF/AFl recurrence after surgical ablation.
Why the study?
Recurrence of AF/AFl after surgical ablation remains difficult to predict, and it was unknown whether combining preoperative TTE and AI-ECG scores improves risk stratification.
Does combining preoperative TTE and AI-ECG scores improve the prediction of AF/AFl recurrence after surgical ablation?
Cohort (n=1,696)
Does combining preoperative TTE and AI-ECG scores improve the prediction of AF/AFl recurrence after surgical ablation?
Preoperative AI-ECG biomarkers and TTE markers of atrial remodeling independently predict AF/AFl recurrence after surgical ablation, improving risk stratification.
Answers are grounded in this paper and cite their sources.
May refine preoperative AF recurrence risk stratification after surgical ablation; leaves open prospective validation before guiding decisions.
Background: Recurrence of atrial fibrillation (AF)/flutter (AFl) after surgical ablation remains difficult to predict. Integration of novel biomarkers may enhance risk stratification. Objective: This study aimed to assess whether combining preoperative transthoracic echocardiography (TTE) and artificial intelligence-enabled electrocardiography (AI-ECG) scores improves the prediction of AF/AFl recurrence after surgical ablation. Methods: We retrospectively analyzed 1696 patients who underwent surgical AF/AFl ablation from 2006 to 2025 with available preoperative TTE and ECG and postblanking (90-day) ECG follow-up. Clinical, TTE, and AI-ECG variables (AF probability, ECG-estimated age, heart failure with preserved ejection fraction, left ventricular dysfunction, and aortic stenosis scores) were assessed. Cox proportional hazards and random survival forest models (80:20 train-test split) identified predictors of recurrence. The final Cox model achieved a concordance index of ∼0.67 and a 3-year Brier score of 0.21, with 3-year freedom-from-arrhythmia rates of ∼85% vs ∼43% for the lowest- vs highest-risk quartiles. Random survival forest modeling yielded a slightly higher concordance index (∼0.69). Conclusion: Preoperative AI-ECG biomarkers (AF probability, age discordance) and TTE markers of atrial remodeling independently predicted AF/AFl recurrence after surgical AF/AFl ablation. Integration of these metrics improved risk stratification.
No takes yet. Share an insight, caveat, or question.
Goings et al. (2025) conducted a cohort in Atrial fibrillation/flutter (n=1,696). Preoperative AI-ECG and TTE biomarkers vs. Lowest-risk quartile was evaluated on AF/AFl recurrence after surgical ablation (C-index 0.67, p== .010). Preoperative AI-ECG and TTE biomarkers independently predicted AF/AFl recurrence after surgical ablation, with 3-year freedom-from-arrhythmia rates of ~43% vs ~85% for highest- vs lowest-risk.
Synapse has enriched 10 related papers. Consider them for comparative context: