arXiv:2606.19373cs.LGcs.AI2026-06

用持续学习让AI记住过往数据,少测几下就能准定位心律失常病灶。

cAPM: Continual AI-Assisted Pace-Mapping with Active Learning

论文配图:cAPM: Continual AI-Assisted Pace-Mapping with Active Learning
图 1 · 摘自论文原文
  • 构建无任务依赖的神经网络,学不同起搏点对应的12导联心电图形态。
  • 仅需4.5次起搏即可在5毫米精度内定位病灶,成功率81%。
  • 适合临床心电图专家和心脏电生理研究者,可大幅减少手术时间。

室性心动过速是危及生命的心律失常,是猝死的主要原因。起搏映射是导管消融术中定位治疗靶点的临床手段,需在心室多点起搏并快速解读心电图以决定下一步位置或是否找到目标。已有主动学习AI模型可引导医生选择下一刺激点,提升效率。但现有方法无法跨病灶或跨患者迁移知识,每次需重新训练。本文提出cAPM,一种持续学习的智能起搏映射框架,能积累并复用历史数据中的知识,减少未来目标所需起搏次数。其核心包括:一个与任务无关的代理神经网络,学习起搏点到12导联心电图形态的映射;基于主动学习策略,每次选择最具有信息量的起搏点优化模型;以及持续学习机制,在不丢失旧知识的前提下依次处理多个目标。在包含多种生理条件和心室几何结构的仿真测试中,cAPM(含/不含历史数据回放)均在4.5次起搏内实现81%的定位成功率(临床容差5毫米),优于当前最优主动学习方法(38%成功率,13.7次起搏)。结果为cAPM向体内预临床及临床研究推进提供了坚实基础。

原文摘要 · Abstract (English)

Ventricular tachycardia is a life-threatening rhythm disorder and a major cause of sudden cardiac death. Pace-mapping is a clinical procedure for identifying the intervention target during catheter ablation of VT. It requires clinicians to pace different sites in the ventricles and rapidly interpret the resulting electrocardiograms to determine where to pace next or whether a target site has been identified. Active learning AI models have been proposed to guide clinicians to the next pacing site, showing promise in reducing the number of pacing sites and improving the efficiency of pace-mapping. Existing methods require retraining each target without the ability to transfer knowledge across multiple VTs within the same patient or across patients. We introduce cAPM for continuous AI-assisted pace-mapping to capture and transfer knowledge accumulated from past pace-mapping data to reduce the number of pace-mapping data needed for future target VTs. This is made possible by a task-agnostic surrogate neural network that learns the mapping from pacing sites to 12-lead ECG morphology, an active-learning strategy that refines this surrogate model by selecting the most informative pacing site for each target, and a continual learning strategy to do so sequentially while retaining knowledge from prior targets. Evaluated on an in-silico testbed consisting of sequentially-presented localization tasks across different physiological conditions and ventricular geometries, cAPM with and without replay of past data samples achieved an 81% probability of localizing within clinical tolerance (5 mm accuracy) using 4.5 pace-mapping sites, compared to the state-of-the-art active-learning method achieving 38% probability using 13.7 pacing sites. These results provide a strong basis for preparing cAPM towards in-vivo preclinical and clinical studies where it can be used to guide pace-mapping.

心电图主动学习持续学习医疗AI

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