AI + ECGs: The Queen of Hearts Tool (EM:RAP Podcast, by Dr. Anand Swaminathan and Dr. Tarlan Hedayati)
In this EM:RAP episode, Drs. Swaminathan and Hedayati explore how PMcardio’s Queen of Hearts™ AI tool is changing ECG interpretation. With 91% accuracy — on par with expert cardiologists — the AI outperforms traditional STEMI criteria, offering emergency clinicians a powerful adjunct for detecting subtle occlusions and improving patient outcomes.
About the Podcast
EM:RAP (Emergency Medicine: Reviews and Perspectives) is one of the most widely followed podcasts in emergency medicine, featuring expert hosts and guest clinicians who break down the latest research and clinical tools shaping practice.
Summary of the Episode
In this episode, Dr. Anand Swaminathan and Dr. Tarlan Hedayati discuss the role of artificial intelligence in ECG interpretation, focusing on the PMcardio Queen of Hearts™ AI tool developed by Dr. Stephen Smith and Dr. Pendell Meyers.
- Queen of Hearts™ is a deep learning model designed to detect occlusive myocardial infarction (OMI) from standard 12-lead ECGs.
- The model achieved 91% accuracy (81% sensitivity, 94% specificity), performing similarly to ECG experts — and far outperforming traditional STEMI criteria (33% sensitivity).
- Unlike conventional ECG computer interpretations (historically 30–70% sensitivity for STEMI), the AI consistently identifies subtle occlusions missed by both machines and clinicians.
- The hosts emphasize that AI cannot replace the clinician at the bedside — it lacks access to serial ECGs, prior patient data, troponins, or echocardiography — but it can act as a valuable adjunct, improving diagnostic accuracy and reducing errors when used appropriately.
- Key takeaway: clinicians must understand the limitations, patient selection, and workflow integration of AI tools to maximize benefit and avoid over-reliance.
“If I could have a Steve Smith in my pocket to read every ECG, that’s what Queen of Hearts feels like. It doesn’t replace us, but it makes us better.”— Dr. Anand Swaminathan, EM:RAP Podcast
🎧 Listen to the episode: Official page
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About PMcardio
PMcardio is a CE-marked Class IIb AI medical device that interprets any 12-lead ECG — from a photo or a digital file — in seconds. It detects 50+ ECG findings, including occlusion myocardial infarction (OMI) — the acute coronary occlusions that conventional STEMI criteria miss in over half of cases. Its Queen of Hearts™ OMI model holds FDA Breakthrough Device Designation, and PMcardio is already used by 100,000+ clinicians who have analyzed more than 2.5 million ECGs.
About Powerful Medical
Powerful Medical is a medical-technology company using artificial intelligence to transform how cardiovascular disease — the world’s leading cause of death — is diagnosed. Founded in 2017, it built PMcardio, the world’s first AI medical device to detect acute coronary occlusion (OMI) from an ECG. Its research is published in the European Heart Journal – Digital Health and validated across 25+ clinical studies, and its Queen of Hearts™ model earned FDA Breakthrough Device Designation. To date, PMcardio has supported the detection of 120,000+ heart attacks across 150+ hospital deployments worldwide.
