{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T16:25:12Z","timestamp":1792686312072,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","funder":[{"DOI":"10.13039\/100000002","name":"National Insitutes of Health","doi-asserted-by":"crossref","award":["K23 HL166977"],"award-info":[{"award-number":["K23 HL166977"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"name":"American Heart Association","award":["23CDA933663"],"award-info":[{"award-number":["23CDA933663"]}]},{"name":"American Heart Association","award":["25POST1361932"],"award-info":[{"award-number":["25POST1361932"]}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R01 HL83359, R01 HL149134, R01 HL1662260, and T32 HL166155"],"award-info":[{"award-number":["R01 HL83359, R01 HL149134, R01 HL1662260, and T32 HL166155"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["R00HL157421, R01HL173526, and R01HL173487"],"award-info":[{"award-number":["R00HL157421, R01HL173526, and R01HL173487"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Drug-induced QT prolongation after successful inpatient loading of class III antiarrhythmics may occur during routine outpatient care. Insertable cardiac monitors offer continuous signals but are limited by single-lead configuration. We hypothesized that a spatially aware deep learning system (3DRECON-QT) can reconstruct spatial information from a single lead vector to quantify QT\/QTc and identify high-risk prolongation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We developed 3DRECON-QT using a multitask encoder\u2013decoder that ingests a 10-s single-lead signal, reconstructs 12 leads, and predicts QT\/QTc. The model was developed using 12-lead ECGs with clinician-adjudicated QT\/RR from a large health system and tested in an external center with different ECG hardware. Continuous monitoring performance was assessed in a public dofetilide\u2010loading data set with serial ECGs. In a real-world cohort of outpatients on dofetilide or sotalol presenting to the hospital or emergency room for any reason, rates of ventricular arrhythmias and QT prolongation were assessed. Device validation was tested in patients with insertable cardiac monitor recordings paired with clinical 12-lead ECGs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      3DRECON-QT classified prolonged QTc from single-lead signals with area under the receiver operating characteristics curve, 0.942 (mean absolute error, 17.5 ms) in the internal test set and 0.943 (mean absolute error, 21.1 ms) externally. During continuous dofetilide monitoring, predictions correlated with ground truth (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      , 0.851; mean absolute error, 17.8 ms; area under the receiver operating characteristics curve, 0.936 for prolonged QTc, 0.816 for \u226515% QTc rise). QTc prediction from true insertable cardiac monitor recordings showed\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      =0.824 and mean absolute error, 17.5 ms. In outpatients on class III antiarrhythmics (n=1676), 16.5% had high-risk QTc prolongation. Ventricular arrhythmia events were 3.97% versus 0.86% without prolongation (adjusted odds ratio, 4.24 [95% CI, 1.81\u20139.90]). 3DRECON-QT detected these events with area under the receiver operating characteristics curve 0.94 (F1 score, 0.60).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>A single-lead, deep-learning approach can achieve guideline-level measurement accuracy, enable continuous QTc surveillance from nonstandard ECG vectors, and identify clinically meaningful outpatient QTc prolongation associated with a &gt;4-fold increase in serious ventricular arrhythmias. This strategy may enhance safety monitoring after class III antiarrhythmic initiation and support targeted intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.125.077494","type":"journal-article","created":{"date-parts":[[2025,11,8]],"date-time":"2025-11-08T16:30:09Z","timestamp":1762619409000},"page":"35-46","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Deep Learning\u2013Based Continuous QT Monitoring to Identify High-Risk Prolongation Events After Class III Antiarrhythmic Initiation"],"prefix":"10.1161","volume":"153","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6153-7272","authenticated-orcid":true,"given":"Rayan A.","family":"Ansari","sequence":"first","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Department of Biomedical Data Science (R.A.A.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4825-646X","authenticated-orcid":true,"given":"Sabyasachi","family":"Bandyopadhyay","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi K.","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (R.T., D.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7698-7353","authenticated-orcid":true,"given":"Kelly A.","family":"Brennan","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8772-5623","authenticated-orcid":true,"given":"Xichong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1885-0690","authenticated-orcid":true,"given":"Prasanth","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9810-6094","authenticated-orcid":true,"given":"J. Weston","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics (J.W.H.), Columbia University Irving Medical Center, New York, NY."},{"name":"Milstein Division of Cardiology (J.W.H.), Columbia University Irving Medical Center, New York, NY."},{"name":"Department of Medicine (J.W.H., X.X.), Columbia University Irving Medical Center, New York, NY."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5482-8055","authenticated-orcid":true,"given":"Alexander C.","family":"Perino","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9418-9577","authenticated-orcid":true,"given":"Euan A.","family":"Ashley","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5467-5877","authenticated-orcid":true,"given":"Paul J.","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2144-2495","authenticated-orcid":true,"given":"Todd","family":"Coleman","sequence":"additional","affiliation":[{"name":"School of Medicine, Department of Bioengineering (T.C.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2746-0202","authenticated-orcid":true,"given":"Marco V.","family":"Perez","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-7518","authenticated-orcid":true,"given":"David","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA (R.T., D.O.)."},{"name":"Division of Research, Kaiser Permanente Northern California, Pleasanton, CA (D.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7552-5053","authenticated-orcid":true,"given":"Sanjiv M.","family":"Narayan","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-534X","authenticated-orcid":true,"given":"Albert J.","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Medicine (R.A.A., S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."},{"name":"Cardiovascular Institute (S.B., K.A.B., X.L., P.G., A.C.P., E.A.A., P.J.W., M.V.P., S.M.N., A.J.R.), Stanford University, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192704"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000527"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.03.038"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000905"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.120.317345"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01407-y"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2014.155"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474x.1997.tb00325.x"},{"key":"e_1_3_3_11_2","unstructured":"Tikosyn (dofetilide) [package insert]. 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