用新型模型提前一小时预测心房颤动,提升早期预警能力。
AF-Mamba: Efficient Long-Term Signal Modeling for Early Prediction of Atrial Fibrillation Onset
- 结合TCN与Mamba的混合架构,高效建模长时间心电序列。
- 在单人五折测试中达0.889敏感度、0.974 AUROC,性能优异。
- 适合可穿戴设备实时监测,兼顾精度与计算效率。
心房颤动(AF)是最常见的心律失常,与中风和心力衰竭风险升高相关。可穿戴及便携式心电图(ECG)监测设备的普及,使得在临床环境外持续评估心律成为可能。提前预测AF发作可为及时临床干预提供额外时间窗口,有助于改善高危患者管理。本研究聚焦于利用一小时内的长期RR间期(RRIs)提前一小时预测AF发作。为此,我们提出一种深度学习架构,融合用于局部特征编码的时序卷积网络(TCNs)与具备长程序列建模能力的Mamba——一种选择性状态空间模型。该混合TCN-Mamba设计可在一小时输入窗口上实现高效训练与推理,克服了Transformer的二次复杂度与循环网络的梯度消失问题。在个体级5折测试中,模型达到0.889敏感度、0.943特异度、0.813 F1分数、0.974 AUROC与0.933 AUPRC。在配对跨数据集留出测试中,AF-Mamba在未见的AF与正常窦性心律(NSR)数据集上仍保持良好区分能力,平均AUROC达0.897。相比现有先进AF预测模型及通用时序模型,AF-Mamba在预测性能上具有竞争力,并在长RR序列处理中展现出更优的性能-效率权衡。结果表明,AF-Mamba具有实现提前一小时准确预测AF并支持实时连续移动监测的潜力。
原文摘要 · Abstract (English)
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with increased risks of stroke and heart failure. The growing availability of wearable and portable ECG monitoring enables continuous assessment of cardiac rhythm outside clinical settings. Predicting AF before its onset could provide additional lead time for timely clinical assessment and potentially improve the management of patients at risk of AF-related complications. This study focuses on predicting AF onset one hour in advance using long-term RR intervals (RRIs). To address this challenge, we propose a deep learning architecture that integrates temporal convolutional networks (TCNs) for local features encoding with Mamba, a selective state-space model capable of long-range sequence modeling. This hybrid TCN-Mamba design enables efficient training and inference on one-hour input windows, overcoming limitations of Transformers' quadratic scaling and recurrent networks' vanishing gradients. In subject-wise 5-fold testing, the proposed model achieved a sensitivity of 0.889, specificity of 0.943, F1-score of 0.813, AUROC of 0.974, and AUPRC of 0.933. In paired cross-dataset holdout evaluation, AF-Mamba maintained discriminative performance across unseen AF and NSR datasets, achieving a mean AUROC of 0.897. Compared against state-of-the-art AF prediction models and general time-series models, AF-Mamba achieved competitive predictive performance while providing a favorable performance-efficiency trade-off for long RRI sequences. These findings demonstrate the potential of AF-Mamba for accurate AF prediction one hour in advance and real-time continuous ambulatory monitoring.
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