Modeling Day-Long ECG Signals to Predict Heart Failure Risk with Explainable AI

Fuente: arXiv
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Main Authors: Zvuloni, Eran, Almog, Ronit, Glikson, Michael, Biton, Shany Brimer, Green, Ilan, Laufer, Izhar, Amir, Offer, Behar, Joachim A.
Format: Preprint
Published: 2025
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author Zvuloni, Eran
Almog, Ronit
Glikson, Michael
Biton, Shany Brimer
Green, Ilan
Laufer, Izhar
Amir, Offer
Behar, Joachim A.
author_facet Zvuloni, Eran
Almog, Ronit
Glikson, Michael
Biton, Shany Brimer
Green, Ilan
Laufer, Izhar
Amir, Offer
Behar, Joachim A.
contents 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, with key attention between 8 AM and 3 PM. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events and circadian variations 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.
format Preprint
id arxiv_https___arxiv_org_abs_2601_00014
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Modeling Day-Long ECG Signals to Predict Heart Failure Risk with Explainable AI
Zvuloni, Eran
Almog, Ronit
Glikson, Michael
Biton, Shany Brimer
Green, Ilan
Laufer, Izhar
Amir, Offer
Behar, Joachim A.
Signal Processing
Artificial Intelligence
Machine Learning
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, with key attention between 8 AM and 3 PM. This study highlights the feasibility of deep learning to model 24-hour continuous ECG data, capturing paroxysmal events and circadian variations 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.
title Modeling Day-Long ECG Signals to Predict Heart Failure Risk with Explainable AI
topic Signal Processing
Artificial Intelligence
Machine Learning
url https://arxiv.org/abs/2601.00014