HRX 2024 AbstracX Library-Optimization of Hybrid Procedures with an Artificial Intelligence System

Optimization of Hybrid Procedures with an Artificial Intelligence System

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The document presents a study on the optimization of hybrid procedures for treating persistent atrial fibrillation (AF) using artificial intelligence (AI). The hybrid convergent procedure combines minimally invasive epicardial radiofrequency (RF) ablation with endocardial ablation. The study explores the use of AI to identify spatiotemporal dispersion—a characteristic of electrograms (EGMs) indicating atypical conduction that may contribute to AF. This aims to develop patient-specific strategies during endocardial ablation.<br /><br />The findings are informed by a trial conducted from November 2021 to August 2022 involving 11 patients. The trial involved two stages: the first was epicardial catheter ablation, and the second was endocardial catheter ablation. AI software processed multipolar EGMs in real-time to identify spatiotemporal dispersion, defined as having least one continuously fractionated electrogram with a cumulative duration greater than 80% of a 1.5-second window.<br /><br />The results suggest that incorporating AI-detected spatiotemporal dispersion into procedures can be a promising addition to the treatment strategy. The outcomes over an 18-month follow-up showed this combined approach to be safe, with no significant complications, although there was one death unrelated to the procedure.<br /><br />In conclusion, the study supports the feasibility and potential effectiveness of combining AI-based spatiotemporal dispersion ablation with hybrid procedures for persistent AF. However, it calls for more research to further validate the approach, given its promising outcomes in terms of safety and efficiency in treating complex cases of AF.

Keywords

atrial fibrillation

artificial intelligence

hybrid procedures

spatiotemporal dispersion

radiofrequency ablation

endocardial ablation

epicardial ablation

electrograms

patient-specific strategies

clinical trial