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Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
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Electrocardiogram Fundamentals01:28

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Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
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Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Electrocardiografía mejorada por inteligencia artificial para la estratificación completa del riesgo de bloqueo

Arunashis Sau1,2, Henry Zhang1, Joseph Barker1

  • 1National Heart and Lung Institute, Imperial College London, London, United Kingdom.

JAMA cardiology
|August 20, 2025
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Resumen

La electrocardiografía mejorada por inteligencia artificial (AI-ECG) puede predecir el riesgo de bloqueo cardíaco completo (CHB). Esta herramienta AI-ECG, AIRE-CHB, ofrece una mejor estratificación del riesgo en comparación con los métodos tradicionales para identificar a los pacientes en riesgo de CHB.

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Área de la Ciencia:

  • Cardiología
  • Inteligencia artificial
  • Diagnóstico médico

Sus antecedentes:

  • El bloqueo cardíaco completo (CHB) es una condición grave con estratificación de riesgo cruda utilizando electrocardiografía de corriente (ECG).
  • El ECG mejorado con inteligencia artificial (AI-ECG) es prometedor para identificar enfermedades subclínicas.
  • Se necesitan métodos mejorados para predecir el CHB incidente.

Objetivo del estudio:

  • Desarrollar y validar un estimador de riesgo AI-ECG para la predicción de CHB de incidentes.
  • Evaluar el rendimiento del modelo AI-ECG con respecto a los factores de riesgo tradicionales.

Principales métodos:

  • Un estudio de cohorte que incluye desarrollo y validación externa.
  • Utilizó una arquitectura de red neuronal convolucional residual con una función de pérdida de supervivencia en tiempo discreto.
  • Entrenado el modelo AI-ECG (AIRE-CHB) para predecir nuevos diagnósticos de CHB.

Principales resultados:

  • AIRE-CHB demostró un fuerte rendimiento predictivo tanto en el desarrollo (índice C 0,836, AUROC 0,889) como en las cohortes de validación (índice C 0,936).
  • El modelo AI-ECG superó significativamente la detección tradicional de bloqueo bifascular (AUROC 0,594).
  • Los individuos de alto riesgo identificados por AIRE-CHB tenían ratios de riesgo sustancialmente mayores para desarrollar CHB.

Conclusiones:

  • Un nuevo modelo de aprendizaje profundo, AIRE-CHB, puede identificar efectivamente el riesgo de CHB incidente.
  • AIRE-CHB tiene el potencial de mejorar la toma de decisiones clínicas en pacientes con síncope o con riesgo de bloqueo atrioventricular de alto grado.
  • Este enfoque AI-ECG ofrece un avance significativo con respecto a los métodos actuales de estratificación del riesgo para CHB.