VISION-ICE: Video-based Interpretation and Spatial Identification of Arrhythmia Origins via Neural Networks in Intracardiac Echocardiography

Abstract

Contemporary high-density mapping techniques and preoperative CT/MRI remain time and resource intensive in localizing arrhythmias. AI has been validated as a clinical decision aid in providing accurate, rapid real-time analysis of echocardiographic images. Building on this, we propose an AI-enabled framework that leverages intracardiac echocardiography (ICE), a routine part of electrophysiology procedures, to guide clinicians toward areas of arrhythmogenesis and potentially reduce procedural time. Arrhythmia source localization is formulated as a three-class classification task, distinguishing normal sinus rhythm, left-sided, and right-sided arrhythmias, based on ICE video data. We developed a 3D Convolutional Neural Network trained to discriminate among the three aforementioned classes. In ten-fold cross-validation, the model achieved a mean accuracy of 66.2% when evaluated on four previously unseen patients (substantially outperforming the 33.3% random baseline). These results demonstrate the feasibility and clinical promise of using ICE videos combined with deep learning for automated arrhythmia localization. Leveraging ICE imaging could enable faster, more targeted electrophysiological interventions and reduce the procedural burden of cardiac ablation. Future work will focus on expanding the dataset to improve model robustness and generalizability across diverse patient populations.