# Electrocardiogram-based deep learning and decision analysis to improve atrial fibrillation risk estimation

> **NIH NIH K23** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $195,810

## Abstract

Project Summary/Abstract
Atrial fibrillation (AF) is a major public health problem resulting in preventable strokes and increased incidence
of heart failure and early cognitive decline. AF is expected to affect nearly 12 million people in the United States
by 2030. Oral anticoagulation (OAC) is highly effective in reducing risk of AF-related stroke, and other preventive
interventions such as weight loss, exercise, and alcohol cessation may reduce risk of AF and associated
complications. However, AF is commonly asymptomatic and is frequently episodic, and therefore may be difficult
to diagnose. Although screening can detect undiagnosed AF, mass screening approaches have not resulted in
meaningful improvements in clinical outcomes. A major inefficiency inherent within current screening approaches
is the screening of many individuals at relatively low risk for AF, leading to an inefficient and low-yield screening
intervention. Therefore, there is a critical unmet need to identify individuals at elevated risk of developing AF
upfront, in order to optimize the efficiency of AF screening and preventive interventions. In Aim 1 of this proposal,
we will develop and compare novel deep learning-based methods to estimate AF risk in an automated fashion
using mobile single-lead electrocardiograms. In Aim 2, we will conduct an individual-level simulation to quantify
the comparative and cost-effectiveness of a risk-based approach to AF screening, as compared to the current
clinical standard of AF screening based on the simple age cutoff of ³65 years. In Aim 3, we will perform a pilot
study to quantify the user acceptability of prospective AF risk estimation and quantify associations between
estimated AF risk and true AF incidence at 18 months. The overall goal of this proposal is to establish the
feasibility and potential clinical value of automated AF risk estimation to guide preventive interventions designed
to reduce the morbidity resulting from AF and its associated complications. The aims will be executed in the
setting of a comprehensive career development program designed to provide Dr. Khurshid, an early career
investigator, with the skills and experience required to become an independent clinician investigator focused on
the improvement of outcomes in cardiac arrhythmias through the use of disease risk prediction. This proposal
impanels a multi-disciplinary team comprising experts in machine learning, decision science, and prospective
clinical studies, who will guide Dr. Khurshid in his transition to scientific independence.

## Key facts

- **NIH application ID:** 10915638
- **Project number:** 5K23HL169839-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Shaan Khurshid
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $195,810
- **Award type:** 5
- **Project period:** 2023-08-15 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10915638

## Citation

> US National Institutes of Health, RePORTER application 10915638, Electrocardiogram-based deep learning and decision analysis to improve atrial fibrillation risk estimation (5K23HL169839-02). Retrieved via AI Analytics 2026-06-15 from https://api.ai-analytics.org/grant/nih/10915638. Licensed CC0.

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