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Artificial intelligence 12-lead electrocardiography to determine atrial fibrillation risk among UK Biobank participants with predisposing conditions

Title: Artificial intelligence 12-lead electrocardiography to determine atrial fibrillation risk among UK Biobank participants with predisposing conditions
Authors: Zheng, Yi; Siontis, Konstantinos C; Attia, Zachi I; Shiri, Isaac; Roten, Laurent; Baj, Giovanni; Kazaj, Pooya Mohammadi; Lopez-Jimenez, Francisco; Gersh, Bernard J; Gräni, Christoph; Reichlin, Tobias; Friedman, Paul A; Windecker, Stephan; Noseworthy, Peter A; Siontis, George C M
Source: European Heart Journal - Digital Health ; volume 7, issue 3 ; ISSN 2634-3916
Publisher Information: Oxford University Press (OUP)
Publication Year: 2026
Description: Aims Artificial intelligence electrocardiography (AI-ECG) algorithms are emerging tools for identifying individuals at risk of atrial fibrillation (AF). We evaluated the predictive performance of a validated AI-ECG algorithm for incident AF in UK Biobank participants with AF risk factors, irrespective of prevalent cardiovascular disease, and its incremental value when added to clinical predictors. Methods and results The AI-ECG tool was applied to sinus rhythm ECGs from UK-Biobank participants with risk factors for AF but no AF. Model performance was evaluated using time-dependent ROC-AUC and Harrell’s C-index. Multivariable Cox regression was used to identify clinical risk factors associated with incident AF and to quantify the contribution of AI-ECG. A total of 21 842 participants (56% male) were included. The median follow-up time was 3.7 years (IQR 0.5–5.4) The ECG-AI tool achieved a ROC-AUC of 0.73 (95% CI 0.68–0.78) at 1 and 0.69 (95% CI 0.66–0.72) at 3 years. A multivariable Cox regression model using clinical parameters achieved a ROC-AUC of 0.71 (95% CI 0.66–0.75) at 1 and 0.71 (95% CI 0.68–0.74) at 3 years. By adding ECG-AI to the clinical Cox regression model, the ROC-AUC increased to 0.75 (95%CI 0.71–0.80) at 1 and 0.74 (95% CI 0.71–0.77) at 3 years. AI-ECG showed a hazard ratio of 1.23 per decile increase (95% CI 1.18–1.27). Conclusion An AI-ECG algorithm improved the prediction of incident AF when added to a clinical parameter-based model over a median follow-up time of 3.7 years among individuals with comorbidities predisposing to AF who may benefit from targeted screening and preventive strategies.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1093/ehjdh/ztag025
DOI: 10.1093/ehjdh/ztag025/66845175/ztag025.pdf
Availability: https://doi.org/10.1093/ehjdh/ztag025; https://academic.oup.com/ehjdh/advance-article-pdf/doi/10.1093/ehjdh/ztag025/66845175/ztag025.pdf; https://academic.oup.com/ehjdh/article-pdf/7/3/ztag025/66845175/ztag025.pdf
Rights: https://creativecommons.org/licenses/by-nc/4.0/
Accession Number: edsbas.DF815D36
Database: BASE