ArticleEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2022
Life-threatening ventricular arrhythmia prediction in patients with dilated cardiomyopathy using explainable electrocardiogram-based deep neural networks.
Article in Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- Artificial Intelligence in the Heart of Medicine: A Systematic Approach to Transforming Arrhythmia Care with Intelligent Systems.Current cardiology reviews · 2025Pooled it
- Redefining Sudden Cardiac Death Risk Stratification in Dilated Cardiomyopathy: An Integrative Approach.Reviews in cardiovascular medicine · 2026Review
- Artificial Intelligence-Enabled Electrocardiography for Prediction of Sudden Cardiac Death and Malignant Ventricular Arrhythmias: A Scoping Review.Journal of cardiovascular development and disease · 2026Review
- The role of comorbidities on periprocedural complications and outcomes in patients with defibrillators and cardiac resynchronization therapy: insights from the German device registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Can atrial fibrillation ablation outcomes be properly predicted with electrocardiography and artificial intelligence?European heart journal. Digital health · 2026Article
- Computer-aided characterization of the arrhythmogenic substrate after myocardial infarction.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Review
- Preoperative risk prediction of major cardiovascular events in noncardiac surgery using the 12-lead electrocardiogram: an explainable deep learning approach.British journal of anaesthesia · 2025Observational
- State of the Art of Artificial Intelligence in Clinical Electrophysiology in 2025: A Scientific Statement of the European Heart Rhythm Association (EHRA) of the ESC, the Heart Rhythm Society (HRS), and the ESC Working Group on E-Cardiology.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Prediction of sudden cardiac death using artificial intelligence: Current status and future directions.Heart rhythm · 2025Review
- Competing risks of monomorphic vs. non-monomorphic ventricular arrhythmias in primary prevention implantable cardioverter-defibrillator recipients: Global Electrical Heterogeneity and Clinical Outcomes (GEHCO) study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Artificial intelligence for ventricular arrhythmia capability using ambulatory electrocardiograms.European heart journal. Digital health · 2024Article
- A review of evaluation approaches for explainable AI with applications in cardiology.Artificial intelligence review · 2024Article
- Clinical Validation of Explainable Deep Learning Model for Predicting the Mortality of In-Hospital Cardiac Arrest Using Diagnosis Codes of Electronic Health Records.Reviews in cardiovascular medicine · 2023Article
- The digital journey: 25 years of digital development in electrophysiology from an Europace perspective.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Review
- Optimizing patient selection for primary prevention implantable cardioverter-defibrillator implantation: utilizing multimodal machine learning to assess risk of implantable cardioverter-defibrillator non-benefit.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Sudden cardiac death after heart transplantation: a population-based study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- Variational auto-encoders improve explainability over currently employed heatmap methods for deep learning-based interpretation of the electrocardiogram.European heart journal. Digital health · 2022Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsWhile electrocardiogram (ECG) characteristics have been associated with life-threatening ventricular arrhythmias (LTVA) in dilated cardiomyopathy (DCM), they typically rely on human-derived parameters. Deep neural networks (DNNs) can discover complex ECG patterns, but the interpretation is hampered by their 'black-box' characteristics. We aimed to detect DCM patients at risk of LTVA using an inherently explainable DNN. METHODS AND
resultsIn this two-phase study, we first developed a variational autoencoder DNN on more than 1 million 12-lead median beat ECGs, compressing the ECG into 21 different factors (F): FactorECG. Next, we used two cohorts with a combined total of 695 DCM patients and entered these factors in a Cox regression for the composite LTVA outcome, which was defined as sudden cardiac arrest, spontaneous sustained ventricular tachycardia, or implantable cardioverter-defibrillator treated ventricular arrhythmia. Most patients were male (n = 442, 64%) with a median age of 54 years [interquartile range (IQR) 44-62], and median left ventricular ejection fraction of 30% (IQR 23-39). A total of 115 patients (16.5%) reached the study outcome. Factors F8 (prolonged PR-interval and P-wave duration, P < 0.005), F15 (reduced P-wave height, P = 0.04), F25 (increased right bundle branch delay, P = 0.02), F27 (P-wave axis P < 0.005), and F32 (reduced QRS-T voltages P = 0.03) were significantly associated with LTVA.
conclusionInherently explainable DNNs can detect patients at risk of LTVA which is mainly driven by P-wave abnormalities.
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