Machine Learning for Predicting Postoperative Atrial Fibrillation After Cardiac Surgery: A Scoping Review of Current Literature

• Published in: The American journal of cardiology Vol. 209; pp. 66 - 75
• Main Authors: El-Sherbini, Adham H., Shah, Aryan, Cheng, Richard, Elsebaie, Abdelrahman, Harby, Ahmed A., Redfearn, Damian, El-Diasty, Mohammad
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15-12-2023; Elsevier Limited
• Subjects: Accuracy; Age; Algorithms; Artificial Intelligence; Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; Cardiac arrhythmia; cardiac surgery; Cardiac Surgical Procedures - adverse effects; Chronic obstructive pulmonary disease; Complications; decision tree; Decision trees; Deep learning; Demographic variables; Diabetes; Electrocardiography; Fibrillation; Glomerular filtration rate; gradient boosting decision tree; gradient-boosted machine; Heart; Heart failure; Heart surgery; Heterogeneity; Humans; Hypertension; k-nearest neighbors; Learning algorithms; Literature reviews; logistic regression; Machine Learning; Mechanical ventilation; neural network; Neural networks; Patients; Postoperative; postoperative atrial fibrillation; postoperative complications; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; random forest; Risk Factors; risk scores; scoping review; Search engines; Software; support vector machine; Support vector machines; Surgery; postoperative atrial fibrillation; random forest; machine learning; risk scores; neural network; artificial intelligence; gradient boosting decision tree; k-nearest neighbors; deep learning; decision tree; support vector machine; gradient-boosted machine; postoperative complications; cardiac surgery; logistic regression; scoping review
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2023.09.079

Postoperative atrial fibrillation (POAF) occurs in up to 20% to 55% of patients who underwent cardiac surgery. Machine learning (ML) has been increasingly employed in monitoring, screening, and identifying different cardiovascular clinical conditions. It was proposed that ML may be a useful tool for predicting POAF after cardiac surgery. An electronic database search was conducted on Medline, EMBASE, Cochrane, Google Scholar, and ClinicalTrials.gov to identify primary studies that investigated the role of ML in predicting POAF after cardiac surgery. A total of 5,955 citations were subjected to title and abstract screening, and ultimately 5 studies were included. The reported incidence of POAF ranged from 21.5% to 37.1%. The studied ML models included: deep learning, decision trees, logistic regression, support vector machines, gradient boosting decision tree, gradient-boosted machine, K-nearest neighbors, neural network, and random forest models. The sensitivity of the reported ML models ranged from 0.22 to 0.91, the specificity from 0.64 to 0.84, and the area under the receiver operating characteristic curve from 0.67 to 0.94. Age, gender, left atrial diameter, glomerular filtration rate, and duration of mechanical ventilation were significant clinical risk factors for POAF. Limited evidence suggest that machine learning models may play a role in predicting atrial fibrillation after cardiac surgery because of their ability to detect different patterns of correlations and the incorporation of several demographic and clinical variables. However, the heterogeneity of the included studies and the lack of external validation are the most important limitations against the routine incorporation of these models in routine practice. Artificial intelligence, cardiac surgery, decision tree, deep learning, gradient-boosted machine, gradient boosting decision tree, k-nearest neighbors, logistic regression, machine learning, neural network, postoperative atrial fibrillation, postoperative complications, random forest, risk scores, scoping review, support vector machine.