Arrhythmias & electrophysiology

Artificial Intelligence–Enhanced Electrocardiography for Complete Heart Block Risk Stratification

JAMA CardiolPublished Prognostic cohort study

Performance · Incident CHB (development cohort)Result — go to the resultAdjusted hazard ratio 11.6 95% CI 7.62–17.7

Authors' conclusion

In this study, a first-of-its-kind deep learning model identified the risk of incident CHB.

Study context

Population
Patients with electrocardiography (ECGs) at Beth Israel Deaconess Medical Center; external validation in UK Biobank volunteer cohort
Participants
189,539 patients · 1,163,401 ECGs
Comparison
AI-ECG risk estimator vs bifascicular block for predicting incident complete heart block (CHB)
Outcome
New diagnosis of complete heart block (CHB) >31 days after the ECG
Methodological detailsdevelopment and external validation
  • Development and external validation

Performance

Incident CHB (development cohort)

Adjusted hazard ratio

11.6

95% CI 7.62–17.7

P < 0.001

By group

AIRE-CHB

C index
0.836 (95% CI, 0.819-0.534)
AUROC for incident CHB within 1 year
0.889 (95% CI, 0.863-0.916)

Bifascicular block

0.594

95% CI 0.567–0.620

AUROC

High-risk quartile vs Low-risk group
aHR 11.6 (95% CI 7.62–17.7); P < 0.001

As reported in the abstract

Further findings

External validation, UK Biobank cohort (50 641 ECGs): incident CHB prediction

C index for incident CHB prediction
0.936 (95% CI, 0.900-0.972)
aHR for incident CHB
7.17 (95% CI, 1.67-30.81; P < .001)

Original publication

Artificial Intelligence–Enhanced Electrocardiography for Complete Heart Block Risk Stratification. JAMA Cardiol. Published 1 November 2025. doi:10.1001/jamacardio.2025.2522

Summarised from the published abstract; every number is checked against it

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