{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T18:33:35Z","timestamp":1784140415931,"version":"3.55.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Science and Technology Council, Taiwan","award":["113-2218_E-008-017 and 113-2640-B-008-001"],"award-info":[{"award-number":["113-2218_E-008-017 and 113-2640-B-008-001"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The recurrence rate of strokes associated with atrial fibrillation (AF) can be substantially reduced through the administration of oral anticoagulants. However, previous studies have not demonstrated a clear benefit from the universal application of oral anticoagulants in patients with embolic stroke of undetermined source. Timely detection of AF remains a challenge in patients with stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aims to develop a convolutional neural network (CNN) model to accurately identify patients with AF using a 12-lead sinus-rhythm electrocardiogram (ECG) recorded around the time of the first ischemic stroke. In addition, this study also evaluates the model\u2019s ability to predict future occurrence of AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A CNN model was trained with ECG data from patients at Taipei Veterans General Hospital. External validation was performed on ischemic stroke patients from National Taiwan University Hospital. The model\u2019s performance was assessed for detecting AF at the stroke event and predicting future AF occurrences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The model demonstrated an area under curve (AUC) of 0.91 for internal validation and 0.69 for external validation in identifying AF at the stroke event, with sensitivity and negative predictive value both achieving 97%. Kaplan\u2013Meier survival analysis of patients without a prior diagnosis of AF revealed a significant increase in future AF incidence among the high-risk group identified by the model (adjusted hazard ratio: 4.06; 95% confidence interval: 2.74-6.00).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The CNN model effectively identifies AF in stroke patients using 12-lead ECGs and predicts future AF events, facilitating early anticoagulation therapy and potentially reducing recurrent stroke risk. Further prospective studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930241302272","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T06:25:21Z","timestamp":1731479121000},"page":"411-418","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["ECG-based machine learning model for AF identification in patients with first ischemic stroke"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2136-2444","authenticated-orcid":false,"given":"Chih-Chieh","family":"Yu","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City"},{"name":"Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qi","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University, Taoyuan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University, Taoyuan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Hsin","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University, Taoyuan"},{"name":"Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei City"},{"name":"Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Min","family":"Liu","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei City"},{"name":"Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei City"},{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yenn-Jiang","family":"Lin","sequence":"additional","affiliation":[{"name":"Heart Rhythm Center, Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei City"},{"name":"Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei City"},{"name":"Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City"},{"name":"Cardiovascular Center, Taichung Veterans General Hospital, Taichung"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian-Yu","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei City"},{"name":"Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Men-Tzung","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences and Engineering, National Central University, 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