{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T17:58:48Z","timestamp":1775843928459,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"crossref","award":["FS\/CRTF\/21\/24183"],"award-info":[{"award-number":["FS\/CRTF\/21\/24183"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"crossref","award":["ACF-2019-21-001"],"award-info":[{"award-number":["ACF-2019-21-001"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]},{"name":"BHF","award":["RG\/16\/3\/32175"],"award-info":[{"award-number":["RG\/16\/3\/32175"]}]},{"name":"BHF","award":["RG\/F\/22\/110078"],"award-info":[{"award-number":["RG\/F\/22\/110078"]}]},{"name":"BHF","award":["PG\/16\/17\/32069"],"award-info":[{"award-number":["PG\/16\/17\/32069"]}]},{"name":"National Institute for Health Research Imperial Biomedical Research Centre"},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["212183\/Z\/18\/Z"],"award-info":[{"award-number":["212183\/Z\/18\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]},{"name":"BHF","award":["FS\/ICRF\/22\/26039"],"award-info":[{"award-number":["FS\/ICRF\/22\/26039"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Accurately determining atrial arrhythmia mechanisms from a 12-lead electrocardiogram (ECG) can be challenging. Given the high success rate of cavotricuspid isthmus (CTI) ablation, identification of CTI-dependent typical atrial flutter (AFL) is important for treatment decisions and procedure planning. We sought to train a convolutional neural network (CNN) to classify CTI-dependent AFL vs. non-CTI dependent atrial tachycardia (AT), using data from the invasive electrophysiology (EP) study as the gold standard.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>We trained a CNN on data from 231 patients undergoing EP studies for atrial tachyarrhythmia. A total of 13\u2009500 five-second 12-lead ECG segments were used for training. Each case was labelled CTI-dependent AFL or non-CTI-dependent AT based on the findings of the EP study. The model performance was evaluated against a test set of 57 patients. A survey of electrophysiologists in Europe was undertaken on the same 57 ECGs. The model had an accuracy of 86% (95% CI 0.77\u20130.95) compared to median expert electrophysiologist accuracy of 79% (range 70\u201384%). In the two thirds of test set cases (38\/57) where both the model and electrophysiologist consensus were in agreement, the prediction accuracy was 100%. Saliency mapping demonstrated atrial activation was the most important segment of the ECG for determining model output.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We describe the first CNN trained to differentiate CTI-dependent AFL from other AT using the ECG. Our model matched and complemented expert electrophysiologist performance. Automated artificial intelligence-enhanced ECG analysis could help guide treatment decisions and plan ablation procedures for patients with organized atrial arrhythmias.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztac042","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T09:28:28Z","timestamp":1660728508000},"page":"405-414","source":"Crossref","is-referenced-by-count":17,"title":["Artificial intelligence-enabled electrocardiogram to distinguish cavotricuspid isthmus dependence from other atrial tachycardia mechanisms"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-7078","authenticated-orcid":false,"given":"Arunashis","family":"Sau","sequence":"first","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safi","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balvinder","family":"Handa","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B","family":"Kramer","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School , 330 Brookline Avenue, Boston, MA 02215 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan W","family":"Waks","sequence":"additional","affiliation":[{"name":"Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School , 330 Brookline Avenue, Boston, MA 02215 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahran D","family":"Arnold","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James P","family":"Howard","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman","family":"Qureshi","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London , Du Cane Road, London W12 0NN , UK"},{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Koa-Wing","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust , Du Cane Road, London W12 0NN , UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Keene","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, 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