Leveraging AI-ECG Technology for Early Notification and Tracking of AF Development (LATENT): A Randomized Controlled Trial.

AI-ECG–guided targeted Holter monitoring modestly increased detection of new AF/AFl or pre-AF atrial findings within 90 days (0.74% vs 0.48%; OR 1.54; P=0.046) in 14,665 adults without prior AF/AFl.

• Why it matters: AF/AFl risk during sinus rhythm is hard to identify early, and the trial tests whether AI-ECG can flag atrial electrical vulnerability to focus surveillance rather than monitor everyone.
• What they did: In a single-center, open-label randomized trial, participants were assigned to AI-ECG strategy or usual care; those labeled high risk in the prior year received ≤7-day Holter, with age- and sex-matched controls monitored similarly.
• The result: The primary composite difference was statistically fragile (reclassification of 1 event shifts P to 0.057) and varied by baseline AI-ECG risk (32.1% vs 2.6% in high risk; 0.4% vs 0.5% in low risk), with no significant differences in AF/AFl detection or antiarrhythmic therapy initiation.

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