{
  "abstract": "Portable, scalable, and accessible artificial intelligence (AI)-enabled smartwatch technology shows promise as a cardiovascular risk stratification strategy in the general adult population. The challenges of lifelong care in congenital heart disease (CHD)—inclusive of regional and socioeconomic disparities worldwide—underscore the need for similar solutions tailored to this population. Herein, we present the first noise-adapted single-lead ECG model for predicting left ventricular systolic dysfunction (left ventricular ejection fraction [LVEF] ≤ 40%) in pediatric and CHD patients. The internal cohort was comprised of 70,226 patients. External test groups included Children’s Hospital of Philadelphia (CHOP; 42,984 patients) and Toronto General Hospital (TGH; 284 repaired tetralogy of Fallot patients). Our model had strong performance across a broad range of CHD lesions, races, ages, and healthcare systems. Our findings support the potential of AI-enabled wearables to expand global access to CHD care. Prospective studies utilizing wearable ECG devices in pediatric and CHD patients are warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA USA",
    "Division of Pediatric Cardiology, Perelman School of Medicine at the University of Pennsylvania, Children’s Hospital of Philadelphia, Philadelphia, PA USA",
    "Computational Health Informatics Program, Boston Children’s Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA USA",
    "Division of Cardiology, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON Canada"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Joshua Mayourian"
    },
    {
      "affs": [
        1
      ],
      "name": "Ivor B. Asztalos"
    },
    {
      "affs": [
        2
      ],
      "name": "William La Cava"
    },
    {
      "affs": [
        0
      ],
      "name": "Ryan L. Kobayashi"
    },
    {
      "affs": [
        0
      ],
      "name": "Sunil J. Ghelani"
    },
    {
      "affs": [
        1
      ],
      "name": "Victoria L. Vetter"
    },
    {
      "affs": [
        3
      ],
      "name": "Rachel M. Wald"
    },
    {
      "affs": [
        0
      ],
      "name": "Anne Marie Valente"
    },
    {
      "affs": [
        0
      ],
      "name": "Tal Geva"
    },
    {
      "affs": [
        0
      ],
      "name": "John K. Triedman"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d519rjz3xg1nq.bib",
  "cited_by": 0,
  "doi": "10.1038/s41746-026-02646-x",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13736832/",
  "id": "d519rjz3xg1nq",
  "issns": [
    "2398-6352"
  ],
  "landing_url": "https://doi.org/10.1038/s41746-026-02646-x",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
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      "openalex",
      "2705|ECG Monitoring and Analysis"
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  "openalex": "W7168026105",
  "pdf_url": "https://www.nature.com/articles/s41746-026-02646-x_reference.pdf",
  "pmcid": "PMC13736832",
  "pmid": "42436248",
  "published": "2026-07-11",
  "publisher": "Nature Publishing Group",
  "ris": "https://research.draconitic.com/paper/d519rjz3xg1nq.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:22:12Z",
      "native_id": "PMC13736832",
      "source": "pmc",
      "url": "https://doi.org/10.1038/s41746-026-02646-x"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|ECG Monitoring and Analysis",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Single lead electrocardiographic detection of left ventricular systolic dysfunction in pediatric and congenital heart disease",
  "title_text": "Single lead electrocardiographic detection of left ventricular systolic dysfunction in pediatric and congenital heart disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:22:12Z",
  "url": "https://research.draconitic.com/paper/d519rjz3xg1nq",
  "venue": "NPJ Digital Medicine",
  "versions": []
}