Applying Artificial Intelligence Algorithms in Daily Clinical Practice to Predict Atrial Fibrillation

Interview With Paul Friedman, MD, FHRS

Dr Paul Friedman will be presenting at the Western Atrial Fibrillation (AFib) Symposium, taking place February 24-25, 2023, in Park City, Utah.

Can you briefly introduce yourself and the focus of your work?

I am Paul Friedman, chair of the department of cardiovascular medicine at Mayo Clinic in the Midwest. I am a practicing electrophysiologist. I treat patients with AFib day in and day out, including offering pharmacologic therapy, ablative therapy, and left atrial appendage occlusion therapy. In a former life, I was a trained electrical engineer, which has been helpful in some of my current activities.

What can you tell us about your upcoming presentation at the Western AFib Symposium?

Technology has changed the way we define AFib. From a patient standpoint, it has always been about possible stroke, symptoms, and a weakening heart pump. It used to be that a 12-lead electrocardiogram (ECG) would make the diagnosis. Then, there were implantable devices, and we started recording very short runs and long runs. The question is, what is AFib? Is it an atrial heart rate above a certain cutoff? We are now taking it one step further with artificial intelligence (AI), and what we have done is apply convolutional neural networks, a form of AI, to look at an ECG. We have also demonstrated this in a watch that acquires during normal rhythm to indicate if the person has had AFib at other times. So, if a patient presents with a stroke, for example, the key question is, have they had AFib? The therapy is completely different, but we do not know. We implant monitors, watch for years, and hope we catch it if it recurs, so that we can offer optimal treatment. But it looks like, and we have demonstrated, that by applying AI to a sinus rhythm ECG, we can detect the presence of AFib other times. I will review in my presentation how that might be working, some of the clinical trials that have been done that are absolutely astounding, and how that is changing the very physics of clinical trials, where we can enroll patients who we saw in clinic 2 years ago by analyzing stored data and applying AI. I will also make some comments about the future, including how this technology may impact our future abilities. I will add that we are currently using it every day at Mayo Clinic as part of our electronic medical record.

What are you most looking forward to at the Western AFib Symposium?

I am excited about the Western AFib Symposium. It will be an opportunity to share best practices, gain insights, and learn from world leaders in AFib. It is the way science advances. We bounce ideas off of each other, we hear what other people are doing, and find better ways to care for our patients jointly to improve the human condition. So, I am excited about the meeting. I look forward to it!