Atrial Fibrillation Recurrence Risk Prediction from 12-lead ECG Recorded Pre- and Post-Ablation Procedure

Eran Zvuloni1, Sheina Gendelman1, Sanghamitra Mohanty2, Jason Lewen3, Andrea Natale2, Joachim A. Behar4
1Faculty of Biomedical Engineering, Technion-IIT, 2Texas Cardiac Arrhythmia Institute, St David's Medical Center, 3BioSig Technologies Inc., 4Technion-IIT


Introduction: 12-lead electrocardiogram (ECG) is recorded during atrial fibrillation (AF) catheter ablation procedure (CAP). It is not easy to determine if CAP was successful without a long follow-up assessing for AF recurrence (AFR). Therefore, an AFR risk prediction algorithm could enable a better management of CAP patients. In this research, we extracted features from 12-lead ECG recorded before and after CAP and train an AFR risk prediction machine learning model.

Methods: Pre- and post-CAP segments were extracted from 112 patients. The analysis included a signal quality criterion, heart rate variability and morphological biomarkers engineered from the 12- lead ECG (804 features overall). 43 out of the 112 patients (n) had AFR clinical endpoint available. These were utilized to assess the feasibility of AFR risk prediction, using either pre or post CAP features. A random forest classifier was trained within a nested cross validation framework.

Results: 36 features were found statistically significant for distinguishing between the pre and post surgery states (n=112). For the classification, an area under the receiver operating characteristic (AUROC) curve was reported with AUROC_pre = 0.64 and AUROC_post = 0.74 (n=43).

Discussion and conclusions: This preliminary analysis showed the feasibility of AFR risk prediction. Such a model could be used to improve CAP management.