AI-RISE to the Challenge — Artificial Intelligence Reduces Time to Treatment in STEMI

The ARISE (Artificial Intelligence–Enabled Rapid Identification of ST-Elevation Myocardial Infarction Using Electrocardiogram) trial randomly assigned patients to either an AI-powered electrocardiogram (AI-ECG) system or standard care and tested the effect of AI-ECG interpretation and automated text-based short message service notification on treatment delays and diagnostic accuracy for patients with ST-segment elevation myocardial infarction (STEMI). The AI-ECG system cut the median door-to-balloon time by 14 minutes (from 96.0 to 82.0 minutes, P<0.001) for patients presenting to the emergency department. The AI-ECG system also decreased the ECG-to-balloon time by 5.6 minutes (from 83.6 to 78.0 minutes, P<0.001) for hospitalized patients. The AI-ECG system also had a high positive and negative predictive value (89.5% and 99.9%), and the AI-ECG group had fewer STEMI activations in patients not requiring emergent angiography. However, the single-center design, short follow-up period, and lack of evaluation of care appropriateness and clinical safety end points limit the study's generalizability. Although the findings suggest that AI-ECG can expedite STEMI diagnosis and treatment, further research is needed to confirm these results in diverse settings and assess the impact on long-term patient outcomes.