Synthetic electrocardiograms for Brugada syndrome: from data generation to expert cardiologists evaluation.
Por:
Zanchi, B, Monachino, G, Faraci, FD, Metaldi, M, Brugada, P, Sarquella-Brugada G, Behr, ER, Brugada-Terradellas J, Crotti, L, Belhassen, B and Conte, G
Publicada:
1 jul 2025
Ahead of Print:
24 abr 2025
Resumen:
AIMS: Synthetic electrocardiograms (ECGs) for inherited cardiac diseases may overcome the issue related to data scarcity for artificial intelligence (AI)-based algorithms. This study aimed to evaluate experienced cardiologists' ability to differentiate synthetic and real Brugada ECGs. METHODS AND RESULTS: A total of 2244 ECG instances (50% synthetic generated by a generative adversarial network, 50% real Brugada patients' ECGs) were evaluated by 7 cardiologists, each with >15 years of experience. All ECGs were standard 12-lead recordings acquired with identical settings (paper speed 25 mm/s, amplitude 10 mm/mV) and randomly assigned without identifying markers. The examination was blinded and conducted in 2 rounds with at least 2 h gap between rounds to assess potential learning effects and intra-rater reliability. Each physician classified the recordings as 'real' or 'synthetic' without having any additional information. Performance metrics, including accuracy, sensitivity, specificity, and intra-rater reliability (Cohen's Kappa), were analyzed. Brugada syndrome (BrS) specialists' repeated evaluations were characterized by low accuracy (first round 40%, second round 42%), specificity (first round 22%, second round 26%) and sensitivity (first round 58%, second round 58%). Intra-rater reliability varied widely (Cohen's Kappa: -0.12 to 0.80). CONCLUSION: Synthetic Brugada ECGs cannot be adequately distinguished from real patients' ECGs by BrS specialists.
Filiaciones:
Zanchi, B:
Inst Digital Technol Personalized Healthcare SUPSI, Dept Innovat Technol, Lugano, Switzerland
Univ Zurich, Dept Quant Biomed, Zurich, Switzerland
Monachino, G:
Inst Digital Technol Personalized Healthcare SUPSI, Dept Innovat Technol, Lugano, Switzerland
Univ Bern, Inst Informat, Bern, Switzerland
Faraci, FD:
Inst Digital Technol Personalized Healthcare SUPSI, Dept Innovat Technol, Lugano, Switzerland
Metaldi, M:
Inst Digital Technol Personalized Healthcare SUPSI, Dept Innovat Technol, Lugano, Switzerland
Brugada, P:
Univ Ziekenhuis Brussel, European Reference Networks Guard Heart, Heart Rhythm Management Ctr, Postgrad Program Cardiac Electrophysiol & Pacing, Brussels, Belgium
Sarquella-Brugada G:
Univ Girona, Dept Ciencies Med, Fac Med, Girona 17003, Spain
Hosp San Juan Dios, Inherited Cardiac Dis & Sudden Death Unit, Arrhythmia, Barcelona, Spain
Inst Recerca St Joan Deu, Arritmies Pediat Cardiol Genetica I Mort Sobtada, Barcelona, Spain
Behr, ER:
Univ London, St Georges Univ Hosp NHS Fdn Trust, Cardiovasc & Genom Res Inst, Cardiovasc Clin Acad Grp, London, England
Brugada-Terradellas J:
Univ Barcelona, Hosp Clin, Cardiol Dept, Arrhythmia Sect, Barcelona, Spain
Crotti, L:
IRCCS, Ist Auxol Italiano, Ctr Cardiac Arrhythmias Genet Origin, Lab Cardiovasc Genet, Milan, Italy
Univ Milano Bicocca, Dept Med & Surg, Milan, Italy
Belhassen, B:
Hadassah Med Ctr, Heart Inst, Jerusalem, Israel
Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel
Conte, G:
Cardioctr Ticino Inst, Div Cardiol, Ente Ospedaliero Cantonale, Via Tesserete 48, CH-6900 Lugano, Switzerland
Univ Svizzera Italiana USI, Fac Biomed Sci, Lugano, Switzerland
Green Submitted, gold
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