Artificial intelligence predicts clinically relevant atrial high-rate episodes in patients with cardiac implantable electronic devices

Min Kim, Younghyun Kang, Seng Chan You, Hyung Deuk Park, Sang Soo Lee, Tae Hoon Kim, Hee Tae Yu, Eue Keun Choi, Hyoung Seob Park, Junbeom Park, Young Soo Lee, Ki Woon Kang, Jaemin Shim, Jung Hoon Sung, Il Young Oh, Jong Sung Park, Boyoung Joung

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


To assess the utility of machine learning (ML) algorithms in predicting clinically relevant atrial high-rate episodes (AHREs), which can be recorded by a pacemaker. We aimed to develop ML-based models to predict clinically relevant AHREs based on the clinical parameters of patients with implanted pacemakers in comparison to logistic regression (LR). We included 721 patients without known atrial fibrillation or atrial flutter from a prospective multicenter (11 tertiary hospitals) registry comprising all geographical regions of Korea from September 2017 to July 2020. Predictive models of clinically relevant AHREs were developed using the random forest (RF) algorithm, support vector machine (SVM) algorithm, and extreme gradient boosting (XGB) algorithm. Model prediction training was conducted by seven hospitals, and model performance was evaluated using data from four hospitals. During a median follow-up of 18 months, clinically relevant AHREs were noted in 104 patients (14.4%). The three ML-based models improved the discrimination of the AHREs (area under the receiver operating characteristic curve: RF: 0.742, SVM: 0.675, and XGB: 0.745 vs. LR: 0.669). The XGB model had a greater resolution in the Brier score (RF: 0.008, SVM: 0.008, and XGB: 0.021 vs. LR: 0.013) than the other models. The use of the ML-based models in patient classification was associated with improved prediction of clinically relevant AHREs after pacemaker implantation.

Original languageEnglish
Article number37
JournalScientific reports
Issue number1
Publication statusPublished - 2022 Dec

Bibliographical note

Funding Information:
This study was supported by research grants from the Korean Healthcare Technology R&D project funded by the Ministry of Health & Welfare (HI15C1200 and HC19C0130) and Abbott Medical Korea Ltd.

Funding Information:
This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI19C0481, HC19C013, HI15C1200) and Abbott Medical Korea Ltd.

Publisher Copyright:
© 2022, The Author(s).

All Science Journal Classification (ASJC) codes

  • General


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