Detect STEMI and OMI with Queen of Hearts™ AI ECG.
Detect true STEMI within seconds. Reduce false cath lab activations. Validated in 15+ peer-reviewed studies involving over 40,000 patients.
STEMI AI ECG Model (pending FDA approval) is considered an investigational device in the US. Not for clinical use.
Queen of Hearts™ (QoH) is a clinically validated AI ECG interpretation model that helps clinicians differentiate true STEMI, including STEMI equivalents, from common ECG mimics that trigger false alarms, such as benign early repolarization (BER), left ventricular hypertrophy (LVH) or pericarditis.
Up to half of patients with Acute Coronary Occlusion are initially missed by STEMI criteria
Heart attacks are the #1 cause of death worldwide
Real Clinical Case
PMcardio® powered by Queen of Hearts™ detects acute coronary occlusion on the first ECG, helping patients reach life-saving treatment hours earlier.
Queen of Hearts™ AI has 2x higher sensitivity and 81% less false positives compared to standard STEMI pathways.
Clinically Proven AI for Faster, More Accurate STEMI Care
Validated in 15+ global studies across 40,000+ patients. Queen of Hearts outperforms standard of care in STEMI detection.
Real-World Implementation in Large Health Systems Shows Faster Door-to-Balloon Times
Queen of Hearts™ AI helps clinicians detect STEMI and STEMI equivalents earlier and make faster triage decisions.
ECGxplain™ - Visual AI Explainability
Visually highlights ECG leads and feature segments influencing the AI prediction, helping clinicians interpret results with confidence.
AI Confidence Score
Provides a probability-based confidence score to support clinical decision-making in borderline or ambiguous ECG cases.
Advanced Ischemia Classification
Classifies STEMI, high-risk NSTEMI, and subendocardial ischemia beyond traditional STEMI criteria.
AI-Supported Chest Pain Triage
Enables earlier recognition of acute coronary occlusion at first medical contact, helping reduce time to reperfusion.
Detection of STEMI Equivalents
Identifies high-risk ischemic ECG patterns such as hyperacute T-waves, posterior STEMI infarctions, and de Winter patterns.
Differentiation of STEMI Mimics
Helps distinguish true coronary occlusion from common STEMI mimics such as LVH, early repolarization, and pericarditis.
“AI-Based ECG Analysis Significantly Improves STEMI Detection, Reduces False Activations”
– ACC News Story, Oct 28, 2025
Main Arena, Transcatheter Cardiovascular Therapeutics (TCT) 2025 (San Francisco)
Presented by: Timothy D. Henry, MD
Discussed by: Ivan Rokos, MD
Why 100,000+ clinicians trust Queen of Hearts AI each month
Beyond STEMI Criteria
Unlike traditional algorithms based on fixed ST-elevation thresholds, Queen of Hearts analyzes the full ECG waveform using deep neural networks to detect subtle patterns of acute coronary occlusion.
Trained on Millions of ECGs
The model is trained on millions of ECGs from an ethnically and racially diverse dataset, enabling robust performance across different patient populations, ECG patterns and subgroups like patients with Left Bundle Branch Block.
Angiography-Based Ground Truth
Training labels are based on coronary angiography and laboratory testing confirming the presence or absence of acute myocardial infarction due to an acute culprit vessel occlusion, not ECG interpretation alone.
Trained by Experts
Built with expert-curated insights from, paramedics, emergency physicians and cardiologists specializing in occlusion myocardial infarction detection for 30+ years.
Works in Any Environment
Queen of Hearts is designed and validated to accurately analyze standard 12-lead ECGs across a wide range of devices used in pre-hospital EMS, emergency departments, and hospital settings.
Certified and Fixed Model
Queen of Hearts is a CE-certified, fixed (locked) clinical algorithm that does not change or retrain during clinical use, ensuring consistent, reproducible performance and regulatory compliance. Available for clinical use in Europe.
Validated in Real-World Practice
The Queen of Hearts has been validated worldwide and is already implemented in 50+ health systems, showing strong performance compared to the Standard of Care.
Prospective Clinical Trials Advancing Acute Cardiovascular Care
Backed by more than 70 peer-reviewed publications, PMcardio continues to advance clinical research to improve the diagnosis and management of acute cardiovascular care worldwide.
TITAN OMI RCT
Evaluate whether real-time AI-assisted ECG interpretation (Queen of Hearts) improves early diagnosis and treatment of OMI in suspected ACS patients without typical STEMI.
Marco Valgimigli
Interventional Cardiologist
Sample size: 500
Recruitment start: August 2025
Status: Recruiting
DIFOCCULT-3 RCT
Tests whether the OMI/Non-OMI paradigm supported by AI ECG improves clinical outcomes (1-year mortality) compared with the traditional STEMI/NSTEMI paradigm.
Emre K. Aslanger
Interventional Cardiologist
Sample size: 6000
Recruitment start: October 2024
Status: Active, recruiting completed
AI ECG TIMI STUDY
Prospectively evaluates Queen of Hearts detection of active coronary occlusion (TIMI 0–1) and associated ECG patterns of acute myocardial infarction.
Robert Herman
Cardiovascular researcher
Sample size: 709
Recruitment start: December 2024
Status: Active, recruiting completed
AZORG STEMI AI
Evaluates the impact of implementing a CE-certified smartphone-based AI platform for ECG interpretation and triage of occlusion myocardial infarction.
Adriaan Wilgenhof
Interventional Cardiologist
Sample size: 8000
Recruitment start: January 2023
Status: Completed
Real-World Cases where Queen of Hearts Helped Saved a Life
“PMcardio’s STEMI AI ECG Model leverages decades of our ECG morphology research to accurately distinguish acute occlusions from patterns which mimic them, going beyond mere ST-elevation analysis.”
Prof. Stephen W. Smith, MD
Emergency Physician
Hennepin County Medical Center
Founder of Dr. Smith’s ECG Blog
“After integrating PMcardio, we noticed a clear drop in false cath lab activations. The AI accurately flags occlusions while minimizing noise, which has saved time, resources, and spared patients unnecessary procedures.”
“I feel so passionately that we should embrace the opportunity and adopt innovation like PMcardio that gives near-perfect accuracy for detecting diagnoses such as Atrial Fibrillation in primary care.”
Dr. Yassir Javaid
Cardiovascular Clinical Lead
East Midlands Clinical Networks,
Clinical Director for Cardiology at Bupa
Clinical Workflow Integration
Queen of Hearts is one of the most extensively validated AI ECG models in cardiovascular care, studied by leading institutions worldwide, and is already used by more than 50 health systems as part of their STEMI protocols, supporting clinical decision-making for patients with suspected acute myocardial infarction.
Used by more than 150 hospitals leveraging AI to streamline cardiac care and improve patient outcomes.
Frequently Asked Questions
What is Queen of Hearts™ (QoH) AI?
Queen of Hearts (QoH) is a clinically validated AI ECG model designed to accurately distinguish true STEMI (requiring emergent cathlab activation) from common mimics such as benign early repolarization (BER) and left ventricular hypertrophy (LVH). It was trained on a global dataset comprising millions of ECGs from chest pain patients, with robust outcome labels based on biomarker rule-out or angiographically confirmed STEMI, including STEMI-equivalent patterns indicative of Occlusion Myocardial Infarction (OMI).
Can I try out the Queen of Hearts™?
Yes, the Queen of Hearts is built into the PMcardio platform, available for individuals or institutions. Download the PMcardio app and get the Queen of Hearts AI interpretation on any image of a 12-lead ECG within seconds.
The Queen of Hearts is a CE-marked medical device under EU MDR and only certified for marketing in the European Union and the United Kingdom. It has not yet been cleared by the US Food and Drug Administration (FDA) for marketing in the USA.
Is the Queen of Hearts™ certified for clinical use?
Yes — in certain regions. Queen of Hearts is Class IIb medical device, CE-marked under the EU Medical Device Regulation (MDR) and approved for clinical use through the PMcardio platform.
In other regions, such as the United States, where it recently received FDA Breakthrough Device Designation it is currently available for research or investigational use pending FDA approval.
For more information on regulatory status and compliance, please visit our Trust center.
Has the Queen of Hearts™ been clinically tested and validated?
Yes. The Queen of Hearts AI model is one of the most clinically validated cardiovascular AI tools to date, having undergone rigorous testing across diverse patient populations. It has been evaluated in thousands of real-world cases across North and South America, Europe, Asia, Australia, and Africa.
🔍 Key highlights from validation studies involving over 10,000 patients:
- 2× higher sensitivity than traditional criteria and standard-of-care interpretation
- 90% reduction in false cath lab activations due to common STEMI mimics
- 100% sensitivity for STEMIs that meet standard STEMI criteria
- Average of 48 minutes saved in door-to-balloon times following implementation
📊 Beyond observational data:
Queen of Hearts is currently the focus of multiple prospective clinical trials and randomized controlled studies (RCTs). These are being conducted across a range of clinical settings—including emergency departments, ambulance systems, and primary care—to further confirm its real-world impact, safety, and effectiveness.
Can I see how Queen of Hearts™ came to its conclusion? Is it explainable AI?
Yes. Powered by the exclusive ECGxplain™ feature, Queen of Hearts offers built-in AI explainability (blue heat maps).
The model highlights specific ECG leads and segments that had the greatest diagnostic influence and provides a confidence score for each prediction. This helps you understand the reasoning behind the output, making it easier to interpret.
Learn more about AI explainability here.
Who is liable if the AI makes a wrong call?
Queen of Hearts is a clinical decision support tool, not a standalone diagnostic system. Just like a lab value, guideline recommendation, or scoring system, it provides clinicians with evidence-based insights to support, not replace, their medical judgment.
The responsibility for final clinical decisions remains with the healthcare provider. Physicians are expected to consider the AI output in the broader context of each patient’s clinical presentation, history, and other diagnostics.
Can the Queen of Hearts™ be used with serial ECGs or to monitor ischemia over time?
Re-running Queen of Hearts on serial ECGs helps detect evolving ischemia or dynamic changes. Currently, the AI model analyzes each ECG individually and does not yet compare serial ECGs over time.
However, in a recent study, Queen of Hearts identified 100% of STEMIs on the first ECG, compared to just 40% with traditional STEMI criteria — highlighting its ability to detect early signs of coronary occlusion even without serial input.
References
LVsense
Rapid assessment of left ventricular (LV) systolic function — directly from a 12-lead ECG.
Core AI
Comprehensive ECG analysis — rhythms, conduction abnormalities, blocks, hypertrophies, and interval measurements.
