JMIR Cardio · Published 2026-06-30 · DOI 10.2196/83714
Jagdeep Sedha, Jukka A Lipponen, Antti Aho, Helena Jäntti, Onni E Santala, Tomi P Laitinen, Tiina M Laitinen, Jari Halonen, Mika P Tarvainen, Eemu-Samuli Seljola, Noora S Naukkarinen, Olli Rantula, Tuomas T. Rissanen, Juha Hartikainen, Tero J Martikainen
Abstract BackgroundAtrial fibrillation (AF), the most prevalent cardiac arrhythmia, affects 2% to 4% of the global adult population and is associated with an increased risk of stroke. Early diagnosis of AF and atrial flutter (AFL) is crucial due to their association with stroke risk and the challenge posed by their often asymptomatic and episodic nature. Traditional electrocardiogram (ECG) interpretation requires substantial expert input and can be challenging, especially with poor-quality ECGs. ObjectiveThis study aimed to evaluate the performance of a deep neural network (DNN) model in detecting AF/AFL from a large, heterogeneous set of long-term ambulatory ECG recordings, including clinical data collected over 6 months at a university hospital, and assess its effectiveness in a setting reflecting the diversity and complexity of real-world clinical data. MethodsThe research combined public datasets totaling 10,248 patients, ECG data from our previous studies (648 patients), and authentic long-term ECG recordings from 4346 patients at Kuopio University Hospital for development of the DNN model. Its clinical accuracy and generalizability were assessed using a separate test dataset consisting of 1039 pseudonymized long-term ECG recordings from 1010 patients, all thoroughly reviewed and annotated by experts. ResultsThe DNN model demonstrated high effectiveness, achieving 96.4% sensitivity and more than 99.99% specificity for time-level AF and AFL detection. At the recording level, it identified AF and AFL with 100% sensitivity and 98.77% specificity, producing false positives in only 1.2% (11/897) of recordings, of which 81.8% (9/11) had other non–AF/AFL arrhythmias. The model maintained high performance across diverse patient characteristics, including varying ages, comorbidities, coexisting arrhythmias, and poor-quality ECG recordings. ConclusionsThe results demonstrate that the proposed DNN model may support automated screening for AF and AFL in long-term ambulatory ECG recordings and may reduce manual review workload in clinical practice.
Abstract from DOAJ. Public domain (CC0 1.0).
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Sedha, J., Lipponen, J., Aho, A., et al. (2026). Deep Neural Networks for Automatic Atrial Fibrillation Detection Using Long-Term Ambulatory Electrocardiography: Retrospective Diagnostic Accuracy Study. JMIR Cardio. https://doi.org/10.2196/83714