Trial reportJournal of the American Heart Association2025
Artificial Intelligence-Enabled ECGs for Atrial Fibrillation Identification and Enhanced Oral Anticoagulant Adoption: A Pragmatic Randomized Clinical Trial.
Trial report in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05127460 (Computer-assisted Atrial Fibrillation Risk Detection In Oral-anticoagulant Use, Lowering Stroke Risk, and Optimizing Guidance With an Intelligent Screening Tool), which is not on this map. Cited by 8 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Computer-assisted Atrial Fibrillation Risk Detection In Oral-anticoagulant Use, Lowering Stroke Risk, and Optimizing Guidance With an Intelligent Screening Tool (CARDIOLOGIST): a Pragmatic Randomized Controlled Trial
Who cites it
8 citing papers in PubMed.
- Artificial intelligence and the evolution of the electrocardiogram: from cardiovascular diagnostic tool to digital biomarker.European heart journal. Digital health · 2026Review
- Artificial intelligence in cardiovascular care: a systematic review and meta-analysis of randomised controlled trials.EClinicalMedicine · 2026Article
- Bridging the gap from clinical to home ECG: quantifying and overcoming accuracy loss in AI-enabled single-lead ECG models.NPJ digital medicine · 2026Article
- Impact of artificial intelligence on cardiovascular workflow, engagement, and outcomes: a systematic review.NPJ digital medicine · 2026Article
- Precision cardiovascular medicine with big data and AI.NPJ digital medicine · 2026Review
- AI-ECG for early diagnosis of atrial fibrillation: an under-utilized tool for preemptive stroke prevention.Annals of medicine and surgery (2012) · 2026Article
- A paradigm shift toward full-cycle management of atrial fibrillation: integrating digital twins and artificial intelligence.Frontiers in cardiovascular medicine · 2026Review
- Artificial intelligence-enabled electrocardiography from scientific research to clinical application.EMBO molecular medicine · 2026Review
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) is often underdiagnosed and undertreated by noncardiologists. This study evaluated whether artificial intelligence-enabled ECG (AI-ECG) alerts could improve AF diagnosis and non-vitamin K antagonist oral anticoagulant prescriptions by noncardiologists.
methodsIn this open-label, cluster randomized controlled trial (NCT05127460) at 2 hospitals in Taiwan, noncardiologists were randomized to an intervention group (AI-ECG alerts) or control group (usual care). Alerts were sent to physicians when AI-ECG identified AF in emergency or hospitalized patients at risk of stroke (CHA₂DS₂-VASc ≥1 for men, ≥2 for women), excluding those with prior AF or oral anticoagulant use. Primary end points included a non-vitamin K antagonist oral anticoagulant prescription within 90 days after discharge, new AF diagnosis, echocardiogram arrangements, and cardiologist visits. Secondary end points were ischemic stroke, cardiovascular death, and all-cause death.
resultsA total of 8857 and 8960 patients were treated by 120 and 113 noncardiologists in the intervention and control groups, respectively; 275 and 245 patients had AI-detected AF. The non-vitamin K antagonist oral anticoagulant prescription rate was significantly higher in the intervention group (23.3% versus 12.0%; hazard ratio [HR], 1.85 [95% CI, 1.11-3.07]). The intervention group also had a higher rate of AF diagnosis (HR, 1.40 [95% CI, 1.03-1.90]). No significant differences were observed in echocardiogram arrangements, cardiologist visits, or the rates of ischemic stroke, cardiovascular death, and all-cause death.
conclusionsAn AI-ECG alert for AF identification promoted non-vitamin K antagonist oral anticoagulant prescriptions among noncardiologists, thus reducing the disparity in AF care quality between cardiologists and noncardiologists. REGISTRATION: URL: https://clinicaltrials.gov/; Unique identifier: NCT05127460.
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