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TRUVACE RECORD VERSION
record: TRV-2026-1736
version: 1
kind: certified
reason: Certified into the record
timestamp: 2026-10-17T22:01:18.747595Z
status: published
lens: g_space
sector: health
headline: Serial Artificial Intelligence ECG-Derived Atrial Fibrillation Probability and Recurrence Risk After Pulsed Field Ablation
dek: Background Pulsed field ablation is now widely used for atrial fibrillation (AF) ablation, but atrial tachyarrhythmia recurrence remains common and postablation risk tools are limited. We assessed whether a validated sinus‑rhythm artificial intelligence- enabled ECG AF probability score, and its early postablation change, predicts recurrence after pulsed field ablation. Methods We studied consecutive patients undergoing index pulsed field ablation across 3 Mayo Clinic sites (February 2024-March 2025) with ≥1 sin…
gain_title: A sinus-rhythm AI-enabled ECG AF probability score, at baseline and in its early postablation change, was associated with recurrence after pulsed field ablation and may support risk stratification.
problem_title: (none)
trace_subject: (none)
gain_reading: A sinus-rhythm AI-enabled ECG AF probability score, at baseline and in its early postablation change, was associated with recurrence after pulsed field ablation and may support risk stratification.
gain_evidence: Higher baseline score independently predicted recurrence | may aid multivariable risk stratification
problem_reading: (none)
problem_evidence: (none)
quick_read: Researchers at three Mayo Clinic sites followed 1052 consecutive patients who had a first pulsed field ablation between February 2024 and March 2025. They calculated an AI-derived AF probability score from sinus-rhythm ECGs taken before the procedure and tracked how it changed in the weeks afterward. About 30% of patients had a recurrence over 188 days.

The findings suggest an existing ECG-based AI score could add information to the limited tools for judging who is likely to have an arrhythmia return after ablation. The authors present it as an aid to multivariable risk stratification rather than a standalone predictor, and they call for prospective validation before it is used in practice.
limitation: The authors state that prospective validation is warranted, so the score's usefulness for risk stratification is not yet confirmed.
tag: Evidence-backed gain
key_points: The cohort had 1052 patients, average age 67, and 33% were women. | Median baseline AI ECG AF score was 0.35, and 320 patients (30%) had recurrence. | Each 0.1 increase in baseline score carried a hazard ratio of 1.08 for recurrence (95% CI 1.03-1.14). | Scores rose on day 0 after ablation and then declined, with less improvement among patients who recurred.
rundown: The study enrolled consecutive patients who had an index pulsed field ablation and at least one sinus-rhythm ECG within 180 days before the procedure. The baseline score, which ranges from 0 to 1, was the mean across all baseline ECGs.

Recovery indices were defined as the mean postprocedure score within days 1-30, 1-60, or 1-90 minus baseline. Each index was used to predict recurrence after matching 30-, 60-, or 90-day blanking windows.

The primary outcome was time to the first documented AF, atrial flutter, or atrial tachycardia episode longer than 30 seconds. It was found through clinic ECGs, ambulatory monitoring, and device interrogations. Cox regression adjusted for clinical and echocardiographic covariates, and discrimination was measured with the Harrell C-statistic.
sources:
- peer_reviewed | Circulation: Arrhythmia and Electrophysiology | https://doi.org/10.1161/circep.126.015183 | 2026-10-08
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