A Standard Heart Test Just Got a Two-Second AI Upgrade

Keypoints:

• Researchers unveiled an AI tool that analyzes a routine ECG in under two seconds
• It flagged up to 81% of heart failure cases and 90% of significant valve disease in a US trial of 67,000 patients
• The model trained on more than 1.6 million ECGs from Brazil and several million from the US
• Findings were presented at the European Society of Cardiology's annual congress in Munich
• Researchers, led by Dr. Ahmed El-Medany of Imperial College London, plan to test it in portable devices next

A standard ECG has recorded the heart's electrical activity for over a century, but it's never been able to detect structural heart disease on its own; that's traditionally required a separate echocardiogram ultrasound. 

A new AI tool presented at the European Society of Cardiology's annual congress in Munich changes that math, extracting subtle electrical patterns invisible to the human eye in under two seconds.

The numbers behind it come from real scale. Researchers, led by Dr. Ahmed El-Medany, a British Heart Foundation research fellow at Imperial College London, trained the model on more than 1.6 million ECGs from Brazil and several million more from the US, linking electrical patterns directly to patients' later diagnoses. 

They then tested the model on roughly 67,000 American patients, where it correctly flagged up to 81% of people with heart failure and up to 90% of those with significant valve disease.

The practical use isn't replacing the ultrasound, it's deciding who needs one most urgently. Heart failure affects more than 6 million Americans and remains a leading cause of hospitalization and death, and much of that burden comes from cases that go undetected until symptoms are already severe. 

Patients flagged as high-risk by the AI could jump to the front of the echocardiogram queue instead of waiting months, and the same model could run automatically across every ECG a hospital performs, catching disease in scans originally ordered for something else entirely, chest pain, pre-operative checks, routine monitoring, quietly surfacing heart problems nobody had reason to suspect yet.

Imperial is already running a smaller prospective study across London and Bristol to test the tool in everyday clinical settings rather than a controlled trial. The next technical goal is shrinking the model into a compact, portable ECG device, the kind that could eventually pull data from wearables and bring this level of screening somewhere closer to a smartwatch than a hospital.