Key result
Single-channel ECG machine learning accurately detects LVEF below 40% with an AUC of ~0.97.
Why the study?
Heart failure symptoms are non-specific and existing diagnostic methods are too complex for screening, creating a need for simple screening tools based on accessible biosignals like single-channel ECG.
Can machine learning algorithms analyzing single-channel ECG accurately detect left ventricular systolic dysfunction compared to echocardiography?
Observational (n=1,224)
Can machine learning algorithms analyzing single-channel ECG accurately detect left ventricular systolic dysfunction compared to echocardiography?
Effect estimate: AUC 0.972
Machine learning analysis of single-channel ECGs provides a highly accurate, simple screening method for detecting left ventricular systolic dysfunction.
May support ECG-based screening for reduced LVEF; leaves open prospective validation before clinical use.
Background and Objectives: Given the non-specificity of symptoms and complex methods for diagnosing heart failure, which are not applicable in screening, it is of great importance to develop a simple screening method for identifying systolic dysfunction of the heart based on available biosignals, one of which is a single-channel electrocardiogram (ECG). The method does not require the participation of medical staff. Aim: To create a screening model for detecting left ventricular systolic dysfunction in a complex analysis of single-channel ECG parameters using machine learning algorithms Methods: We included 624 patients aged 18 to 90 years. All patients underwent echocardiography and single-channel I-lead ECG recording using a portable electrocardiograph. The left ventricle ejection fraction (LV EF) was determined in the apical 2-chamber and 4-chamber view using the BIPLANE Simpson method and confirmed by two independent experts. Single-channel ECG analysis was performed using advanced signal processing and machine learning techniques. Results: For identifying LV EF below 52% in men and below 54% in women, the best result was demonstrated by “Lasso regression”: sensitivity 79.2%, specificity 81.7%, AUC = 0.849. For detection of LVEF below 40%, the “Extra Trees” model was the best, with a sensitivity of 83.1% and a specificity of 82.7%, AUC = 0.972. External testing of the algorithm was conducted on a sample of 600 patients. The accuracy was 98%, specificity 98.4%, and sensitivity 93.5%. Conclusions: The results indicate quite high diagnostic accuracy of screening for left ventricular systolic dysfunction when analyzing single-channel ECG parameters using modern signal processing and machine learning technologies.
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Kuznetsova et al. (2026) conducted an observational in Left ventricular systolic dysfunction (n=1,224). Machine learning analysis of single-channel ECG vs. Echocardiography (BIPLANE Simpson method) was evaluated on Detection of left ventricular ejection fraction below 40% (AUC 0.972). Machine learning analysis of single-channel ECG accurately detected left ventricular ejection fraction below 40% with a sensitivity of 83.1%, specificity of 82.7%, and an AUC of 0.972.
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