Can AI Outperform Doctors in ECG Interpretation? (RCEM Learning Podcast, by Dr. Andy Neill and Dr. Dave McCreary)
In this RCEM Learning Podcast episode, Andy and Dave explore a study comparing doctors and PMcardio’s Queen of Hearts™ AI in ECG interpretation. Physicians achieved ~65% accuracy, while the AI reached ~89%, outperforming even cardiologists in spotting subtle occlusions — a shift with major implications for emergency medicine.
About the Podcast
RCEM Learning Podcast is produced by the Royal College of Emergency Medicine, bringing evidence-based discussions, case reviews, and critical updates to frontline emergency clinicians. Each episode features practicing emergency physicians sharing perspectives on research and clinical practice.
Summary of the Episode
In this episode, hosts Dr. Andy Neill and Dr. Dave McCreary review a recent study published in the American Journal of Emergency Medicine comparing physicians with PMcardio Queen of Hearts™ AI for cath lab activation decisions.
- The study tested 18 ECGs: 8 STEMI equivalents, 8 STEMI mimics, 1 STEMI, and 1 normal ECG.
- Results showed emergency physicians and cardiologists both averaged ~65% accuracy, while the AI achieved ~89% accuracy.
- Humans struggled most with transient STEMI, hyperacute T-waves, de Winter’s pattern, and left bundle branch block, whereas the AI consistently identified these with far greater accuracy.
- The discussion highlighted how AI may reduce missed occlusions and unnecessary cath lab calls — but also raised important questions about over-reliance, medical education, and future training priorities for emergency physicians
“Docs are only about two thirds accurate on the toughest ECGs. Queen of Hearts nails close to 90 percent — meaning fewer missed heart attacks and fewer unnecessary cath lab calls.”— Dr. Dave McCreary, RCEM Learning
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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.
