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AI detects heart failure and valve disease from a standard ECG in under two seconds

AI detects heart failure and valve disease from a standard ECG in under two seconds

New Capabilities

Imperial College London's AI ECG tool moves to commercialisation via Cardiovolt.ai spinout, pending NHS trial results and regulatory approval

September 28th, 2026: Cardiovolt.ai named as spinout commercialising the AI ECG research

Overview

Updated Sep 28

An AI tool built at Imperial College London reads heart failure and heart valve disease from a standard electrocardiogram (ECG), a test in clinical use for a century. In a 67,000-patient US trial, it flagged up to 81 percent of heart failure cases and 90 percent of valve disease cases. Each read takes under two seconds.

Those conditions normally need an echocardiogram, an ultrasound scan patients can wait months to get. The tool doesn't make the diagnosis; it decides who gets scanned first. The work is being commercialised through Cardiovolt.ai, a spinout, but the results are conference-stage, not peer-reviewed, and the 590-patient NHS trial must clear regulatory review.

Why it matters

If the NHS trial and regulatory review pass, a test run a billion times a year could fast-track the heart patients who need treatment most.

Questions about this story

Free account needed to ask — your question is kept and asked for you right after sign-up. Answers are public.

0

Could these things be detected from an EKG before this product?

Yes — heart failure and valve disease were detectable before, but only with echocardiograms, physical exams, or biomarkers; no ECG-based test could flag them at scale until this AI.

Why it matters: The breakthrough isn't that the conditions can be found at all — it's that a cheap, ubiquitous, 10-second test can now surface them in patients who'd otherwise go unnoticed.

  • The standard route before this AI: a doctor suspects a problem from symptoms (breathlessness, fatigue) or an abnormal physical exam, then refers the patient for an echocardiogram — an ultrasound that directly images heart structure and pumping function.
  • ECGs alone couldn't reliably reveal heart failure or valve disease — they only record electrical activity, which is why the research team says the AI extracts information 'the human eye can't see' from a test that was 'not designed to detect either condition'.
  • Blood tests like BNP (B-type natriuretic peptide) can suggest heart failure, but they can't identify which valve is affected, and they aren't part of routine screening.
  • The persistent failure this AI addresses isn't detection in principle — it's triage: patients can wait months for an echocardiogram, and the AI lets high-risk cases skip the queue.
Sources
Room for disagreement
  • Some cardiologists argue the pre-AI toolkit — echocardiography and biomarkers — already caught these conditions adequately in symptomatic patients, and the real gap is only in asymptomatic screening, which the AI is still unproven at.
  • Coverage of the accuracy figures varies: the researchers report 77–90% detection depending on the cohort, but the results are conference-stage, not peer-reviewed, and the 590-patient NHS trial is still pending regulatory approval — some commentators caution the real-world performance may be lower.
AI-generated with web search — may be wrong. Check the linked sources.
0

How soon will these machines be available for everyone to use?

The team behind the AI ECG tool estimates it could be in routine NHS use in about two years — but that depends on the 590-patient NHS trial clearing regulatory review, and some analysts say wider adoption could take 3–7 years.

Why it matters: Heart failure and valve disease patients can wait months for an echocardiogram; this tool is designed to fast-track the highest-risk ones, so the timeline determines how soon waiting lists shrink.

  • The AI is now being tested on ECGs from 590 NHS patients across London (Chelsea and Westminster, West Middlesex, Hammersmith, St Mary's) and Bristol (Bristol Royal Infirmary, Southmead), with routine use forecast at about two years away. [chelwest.nhs.uk](https://www.chelwest.nhs.uk/about-us/news/ai-tool-that-can-spot-heart-disease-in-less-than-2-seconds-to-be-trialled-at-trust)
  • Cardiovolt.ai, the Imperial College spinout commercialising the tool, is pursuing regulatory approval in the UK, EU, and US — a required step since the tool makes a clinical claim (flagging patients for referral). It has raised £1.4M so far. [imperial.ac.uk](https://www.imperial.ac.uk/news/articles/admin-services/enterprise/2026/cardiovoltai-turns-heart-traces-into-powerful-diagnostic-tools/)
  • The tool is not a standalone diagnostic — it flags high-risk patients for an echocardiogram — so its real-world impact on outcomes has not yet been shown. [thenextweb.com](https://thenextweb.com/news/imperial-ai-ecg-heart-disease-detection)
  • Successful trial results alone won't settle the timeline: the UK has unresolved regulatory questions about AI medical devices, and the current version has not yet gone through the clinical-validation and approval process. [thenextweb.com](https://thenextweb.com/news/imperial-ai-ecg-heart-disease-detection)
Room for disagreement
  • The two-year figure is the research team's own forecast — a 'research ambition,' not a confirmed schedule. TNW and The Rundown AI note that regulatory approval and clinical validation could push deployment beyond that window. [therundown.ai](https://www.therundown.ai/news/imperial-ai-ecg-heart-disease-detection)
  • Other coverage is more cautious: Near Future puts the gap between clinical validation and widespread hospital adoption at 3–7 years, and notes the current results show what the AI can extract from an ECG, not yet whether using it changes patient outcomes. [en.futuroprossimo.it](https://en.futuroprossimo.it/2026/09/unai-legge-lelettrocardiogramma-e-batte-i-cardiologi-in-2-secondi/)
AI-generated with web search — may be wrong. Check the linked sources.

Key Indicators

590
NHS patients in UK trial
The model is being tested on 590 patients across London and Bristol to check accuracy on UK ECG machines and patients.
2 yrs
Team's target for routine NHS use
Researchers say the AI could be used routinely within two years, though regulatory approval and adoption remain uncertain.

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People Involved

Organizations Involved

Timeline

August 2026 September 2026

5 events Latest: September 28th, 2026 · 1 week ago
Tap a bar to jump to that date
  1. Cardiovolt.ai named as spinout commercialising the AI ECG research

    Latest Business

    Reporting identifies Cardiovolt.ai as the spinout commercialising the Imperial College tool, with Prof Fu Siong Ng as chief medical officer and Dr Arunashis Sau as chief scientific officer. The system has not yet passed UK regulatory review.

  2. Optimist Daily highlights screening potential

    Media coverage

    Coverage emphasizes the tool's role in flagging high-risk patients for faster echocardiograms.

  3. British Heart Foundation publishes trial details

    Statement

    BHF releases technical breakdown, AUC scores, and the 590-patient NHS trial plan.

  4. Guardian reports 'superhuman AI' tool

    Media coverage

    First major coverage describes the AI spotting heart disease in less than two seconds.

  5. ESC Congress opens in Munich

    Conference

    Imperial College team presents AI ECG results to thousands of cardiology delegates.

Scenarios

1

AI ECG clears NHS trial, reaches routine use by 2028

Possible Resolves by End of 2028

Discussed by: The Imperial College research team (El-Medany, Ng) and the British Heart Foundation

The 590-patient NHS trial in London and Bristol confirms the model's accuracy in UK patients. The team secures regulatory clearance and integrates the tool into hospital ECG workflows, running it on every ECG performed. The stated target is routine use within two years of the Munich presentation.

2

NHS trial shows performance dip, adoption slips

Unlikely Resolves by Aug 31, 2028

Discussed by: Caveats in the research: the model was trained on US data, and UK ECG machines and patient populations differ

The algorithm performs worse on UK ECGs than on US data. Different equipment, filtering settings, and patient demographics degrade accuracy. The team must retrain the model and repeat trials, pushing routine use beyond the two-year goal and delaying the promised screening benefit.

3

Handheld AI ECG reader enters clinical trials

Likely Resolves by End of 2027

Discussed by: Dr. Ahmed El-Medany, who named portable devices as the next research question

Strong initial results lead the team to pair the algorithm with a compact, portable ECG device designed for community and primary care settings. If it works, screening for heart failure and valve disease moves out of hospitals entirely, reaching patients who never get a referral for an ultrasound.

4

Cardiovolt.ai clears UK regulatory review, NHS deployment follows

Possible Resolves by End of 2028

Discussed by: TNW reporting on the spinout and UK medical device requirements

The spinout completes clinical validation and meets UK medical device rules, then runs the AI on ECGs across hospital workflows. Routine NHS use within the team's two-year target would follow, though false alerts could add scan burden.

5

Live clinics reveal high false-alert rate, straining scan services

Uncertain Resolves by End of 2027

Discussed by: The Rundown AI, noting detection percentages do not establish alert reliability in routine care

The reported detection rates do not show how often alerts prove unfounded. In routine use, false alerts could send many patients for unnecessary echocardiograms, adding pressure to strained services and forcing workflow changes.

Historical Context

3 moments from history that rhyme with this story — and how they unfolded.

March 2019

Mayo Clinic's AI-ECG for weak heart pump (2019)

Cardiologist Paul Friedman's team at Mayo Clinic trained an AI on tens of thousands of 10-second ECGs to detect a weak heart pump (low left ventricular ejection fraction), a hallmark of heart failure. The model read signals invisible to the human eye and flagged patients with impaired pump function, published in Nature Medicine.

Then

The study showed the concept worked, but it was a proof of principle, not a deployed tool.

Now

It established that AI can extract hidden cardiac information from a standard ECG, laying the groundwork for the Imperial College tool.

Why this matters now

This is the direct predecessor: the same condition (reduced pumping function), the same test (standard ECG), and the same approach (deep learning on ECG waveforms). The Imperial tool extends the concept to valve disease and scales it to millions of records.

November 2017 - March 2019

Apple Heart Study (2017-2019)

Stanford Medicine worked with Apple to enroll 419,000 participants in a study using the Apple Watch's optical heart sensor to detect irregular pulses suggesting atrial fibrillation, a common heart rhythm disorder. The research showed a consumer wearable could flag a condition many people didn't know they had.

Then

The study reported a 0.84 percent rate of irregular pulse notifications, with most flagged participants confirmed to have atrial fibrillation.

Now

Apple's ECG app gained FDA clearance in 2018, demonstrating how AI-driven screening moves from research to regulated devices.

Why this matters now

Shows the typical path an AI screening tool travels: research validation, regulatory clearance, then deployment. The Imperial ECG tool is at the same early stage Apple's watch was in 2017.

April 2021 - August 2023

MASAI trial: AI-assisted mammography (2023)

Swedish researchers randomized 80,000 women to AI-supported or standard mammography screening. The AI-assisted arm detected 20 percent more cancers (244 vs 203) with a lower recall rate, published in The Lancet Oncology. It was the first large randomized trial showing AI improves a standard screening test in real clinical practice.

Then

The AI group caught more cancers without increasing false alarms, prompting calls for broader adoption.

Now

It set the evidence bar for AI screening tools: randomized controlled trials, not retrospective validation.

Why this matters now

The Imperial ECG tool has replicated the mammography AI's retrospective results. To reach routine use, it must clear the same hurdle MASAI did: prove real-world benefit in a prospective trial, which the 590-patient NHS study begins to address.

Sources

(9)