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Modeling day-long ECG signals to predict heart failure risk with explainable AI.

Created on 20 Jun 2026

Authors

Eran Zvuloni, Ronit Almog, Michael Glikson, Shany Brimer Biton, Ilan Green, Izhar Laufer, Offer Amir, Joachim A Behar

Published in

NPJ digital medicine. Jun 19, 2026. Epub Jun 19, 2026.

Abstract

Heart failure (HF) affects 11.8% of adults aged 65 and older, reducing quality of life and longevity. Preventing HF can reduce morbidity and mortality. We hypothesized that artificial intelligence (AI) applied to 24-hour single-lead electrocardiogram (ECG) data could predict the risk of HF within five years. To research this, the Technion-Leumit Holter ECG (TLHE) dataset, including 69,663 recordings from 47,729 patients, collected over 20 years, was used. Our deep learning model, DeepHHF, trained on 24-hour ECG recordings, achieved an area under the receiver operating characteristic curve of 0.80 that outperformed a model using 30-second segments and a clinical score. High-risk individuals identified by DeepHHF had a two-fold chance of hospitalization or death incidents. Explainability analysis showed DeepHHF focused on arrhythmias and heart abnormalities. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events essential for reliable risk prediction. Artificial intelligence applied to single-lead Holter ECG is non-invasive, inexpensive, and widely accessible, making it a promising tool for HF risk prediction.

PMID:
42321372
Bibliographic data and abstract were imported from PubMed on 20 Jun 2026.

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