AI-enabled ECGs may identify patients at greater risk of stroke,
cognitive decline

Date:
May 2, 2022
Source:
Mayo Clinic
Summary:
Atrial fibrillation, the most common cardiac rhythm abnormality,
has been linked to one-third of ischemic strokes, the most common
type of stroke.

But atrial fibrillation is underdiagnosed, partly because many
patients are asymptomatic.



FULL STORY ========================================================================== Atrial fibrillation, the most common cardiac rhythm abnormality, has
been linked to one-third of ischemic strokes, the most common type of
stroke. But atrial fibrillation is underdiagnosed, partly because many
patients are asymptomatic.


========================================================================== Artificial intelligence-enabled electrocardiography (ECG) was recently
shown to identify the presence of brief episodes of atrial fibrillation,
and the ability of an AI-enabled ECG algorithm to predict atrial
fibrillation up to 10 years before clinical diagnosis has been confirmed
in a population-based study conducted by Mayo Clinic researchers.

A new population-based study from Mayo Clinic now offers evidence that
the algorithm can help identify patients at greater risk of cognitive
decline. AI- enabled ECG that shows high probability of atrial
fibrillation also was associated with the presence of infarctions,
or incidents of cerebral stroke, on MRI, according to the study.

The study is described in an article, "Artificial Intelligence-Enabled Electrocardiogram for Atrial Fibrillation Identifies Cognitive
Decline Risk and Cerebral Infarcts," which is published in Mayo Clinic Proceedings.

Most of the infarctions observed were subcortical, meaning that they
occurred in the region of the brain below the cortex. This suggests
that AI-enabled ECG not only predicts atrial fibrillation, but also
detects other cardiac disease markers and correlates with small vessel cerebrovascular disease and cognitive decline.

"This study finds that artificial intelligence-enabled electrocardiography acquired during normal sinus rhythm was associated with worse baseline cognition and gradual decline in global cognition and attention," says
Jonathan Graff-Radford, M.D., a Mayo Clinic neurologist and the study's corresponding author. "The findings raise the question whether initiation
of anticoagulation is an effective and safe preventive strategy in
individuals with a high AI-ECG algorithm score for reducing the risk
of stroke and cognitive decline." Prospective controlled studies are
needed to determine whether a high atrial fibrillation score on an
AI-enabled electrocardiogram could be a biomarker to identify patients
for anticoagulation or more aggressive stroke risk factor modification,
Dr. Graff-Radford says.

The retrospective study reviewed sinus-rhythm ECG of 3,729 patients
with a median age of 74 years who were enrolled in the Mayo Clinic Study
of Aging between 2004 and 2020. Adjusting for demographic factors, the AI-enabled ECG atrial fibrillation score correlated with lower baseline
and faster decline in global cognitive scores. About one-third of the
patients who underwent ECG also had an MRI, and high atrial fibrillation probability in the ECG correlated with MRI-detected cerebral infarcts.

"Application of this AI-ECG algorithm may be another way to screen
individuals not only to determine risk of atrial fibrillation, but
also to identify future risk of cognitive decline and stroke," says
Dr. Graff-Radford.

Research reported in the article was supported by grants from the National Institute on Aging and the National Institutes of Health. The study was
made possible by the Rochester Epidemiology Project. Potential competing interests are identified in the article. Among the potential competing interests, Peter Noseworthy, M.D., a Mayo Clinic cardiologist, and Mayo
Clinic have filed patents related to the application of AI to ECG for
diagnosis and risk stratification.


========================================================================== Story Source: Materials provided by Mayo_Clinic. Original written by
Jay Furst. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Erika L. Weil, Peter A. Noseworthy, Camden L. Lopez, Alejandro A.

Rabinstein, Paul A. Friedman, Zachi I. Attia, Xiaoxi Yao,
Konstantinos C.

Siontis, Walter K. Kremers, Georgios Christopoulos, Michelle
M. Mielke, Prashanthi Vemuri, Clifford R. Jack, Bernard J. Gersh,
Mary M. Machulda, David S. Knopman, Ronald C. Petersen, Jonathan
Graff-Radford. Artificial Intelligence-Enabled Electrocardiogram
for Atrial Fibrillation Identifies Cognitive Decline Risk and
Cerebral Infarcts. Mayo Clinic Proceedings, 2022; 97 (5): 871 DOI:
10.1016/j.mayocp.2022.01.026 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/05/220502120505.htm

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