ClinicalTrials.gg
Not yet recruitingNCT07774689Updated Aug 19, 2026

AI-ECG for Preoperative Cardiovascular Risk Stratification Before General Surgery

An interventional study of AI-ECG-based preoperative risk stratification (ECG Buddy) in Perioperative Cardiovascular Risk, Postoperative Complications (Cardiopulmonary) and Preoperative Care, sponsored by Seoul National University Bundang Hospital. Not yet recruiting at 1 site in South Korea. Open to participants aged 20 Years and older. Per ClinicalTrials.gov, last updated 2026-08-19.

Sponsored by Seoul National University Bundang Hospital · Not applicable, Interventional, and Health services research

Phase
Not applicable
Study type
Interventional
Enrollment
3,200
Allocation
Randomized
Ages
20 Years and older
Sex
All
01

Study summary

This randomized controlled trial evaluates whether an artificial intelligence-enhanced electrocardiography (AI-ECG)-based strategy for preoperative cardiovascular risk stratification is noninferior to usual care in patients undergoing elective general surgery. Eligible patients are randomly assigned to either an AI-ECG-guided preoperative assessment strategy or usual preoperative care.

The primary outcome is the incidence of major adverse cardiovascular events (MACE) within 30 days after surgery, defined as a composite of all-cause death, ventricular fibrillation/tachycardia or cardiac arrest, non-fatal myocardial infarction, unplanned revascularization (PCI or CABG), mechanical ventilation for ≥3 days, and acute heart failure requiring intravenous diuretics.

Secondary outcomes include the rate of preoperative cardiac imaging and functional testing (echocardiography, coronary CT, SPECT, stress test), the rate of preoperative cardiology consultation, length of hospital stay, direct medical costs, and the time required for preoperative evaluation. The study aims to determine whether AI-ECG can safely guide preoperative cardiovascular evaluation while reducing unnecessary testing, resource use, and cost.

02

Conditions studied

  • Perioperative Cardiovascular Risk
  • Postoperative Complications (Cardiopulmonary)
  • Preoperative Care

Keywords

  • Artificial intelligence
  • Electrocardiography
  • Perioperative cardiovascular risk
  • Preoperative evaluation
  • Major adverse cardiovascular events
03

In context

Postoperative Complications

1,332 studies on the registry are indexed under Postoperative Complications; 311 are open to participants now.

This study's planned enrollment of 3,200 is above the median of 114 across 766 interventional studies indexed under Postoperative Complications.

Browse Postoperative Complications studies →

Lead sponsor

Seoul National University Bundang Hospital is the lead sponsor of 376 studies on the registry; 56 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
20 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adults aged 20 years or older
  • Patients scheduled for elective (non-emergent) general surgery
  • Willing and able to provide voluntary written

Exclusion criteria

Exclusion Criteria:

  • Emergency surgery
  • Surgery under local anesthesia
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Phase
Not applicable
Primary purpose
Health services research
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
3,200 participants (estimated)

Study arms

  • Experimental
    AI-ECG-guided preoperative strategy

    Patients undergo preoperative cardiovascular risk stratification guided by the output of the AI-ECG device (ECG Buddy). Further preoperative cardiovascular evaluation and cardiology consultation are directed according to the AI-ECG-based assessment.

    Diagnostic Test: AI-ECG-based preoperative risk stratification (ECG Buddy)

  • No intervention
    Usual care

    Patients receive usual preoperative care for cardiovascular evaluation according to standard institutional practice, without use of the AI-ECG-based strategy.

Interventions

  • Diagnostic testAI-ECG-based preoperative risk stratification (ECG Buddy)

    A standard 12-lead ECG is analyzed by an AI-enhanced ECG algorithm (ECG Buddy) to stratify preoperative cardiovascular risk. Designated AI-ECG biomarkers are used as decision thresholds to guide subsequent preoperative cardiovascular evaluation and cardiology consultation.

06

What researchers measure

Primary outcomes

  1. Incidence of major adverse cardiovascular events (MACE) within 30 days after surgery

    Composite of all-cause death, ventricular fibrillation/tachycardia or cardiac arrest, non-fatal myocardial infarction, unplanned revascularization (PCI or CABG), mechanical ventilation for ≥3 days, and acute heart failure requiring intravenous diuretics.

    Time frame: Within 30 days after surgery

Secondary outcomes

  1. Rate of preoperative cardiac imaging and functional testing

    Proportion of patients undergoing preoperative echocardiography, coronary CT, SPECT, or stress testing.

    Time frame: From randomization to surgery, up to 24 weeks

  2. Rate of preoperative cardiology consultation

    Time frame: From randomization to surgery, up to 24 weeks

  3. Length of hospital stay

    Time frame: Through hospital discharge (up to 30 days)

  4. Direct medical costs

    Time frame: Within 30 days after surgery

  5. Time required for preoperative evaluation

    Time frame: From randomization to surgery, up to 24 weeks

07

Study locations

1 site
08

References and documents

Publications

  • Cho Y, Yoon M, Kim J, Lee JH, Oh IY, Lee CJ, Kang SM, Choi DJ. Artificial Intelligence-Based Electrocardiographic Biomarker for Outcome Prediction in Patients With Acute Heart Failure: Prospective Cohort Study. J Med Internet Res. 2024 Jul 3;26:e52139. doi: 10.2196/52139. PubMed 38959500 ↗
  • Siontis KC, Noseworthy PA, Attia ZI, Friedman PA. Artificial intelligence-enhanced electrocardiography in cardiovascular disease management. Nat Rev Cardiol. 2021 Jul;18(7):465-478. doi: 10.1038/s41569-020-00503-2. Epub 2021 Feb 1. PubMed 33526938 ↗
  • Thompson A, Fleischmann KE, Smilowitz NR, de Las Fuentes L, Mukherjee D, Aggarwal NR, Ahmad FS, Allen RB, Altin SE, Auerbach A, Berger JS, Chow B, Dakik HA, Eisenstein EL, Gerhard-Herman M, Ghadimi K, Kachulis B, Leclerc J, Lee CS, Macaulay TE, Mates G, Merli GJ, Parwani P, Poole JE, Rich MW, Ruetzler K, Stain SC, Sweitzer B, Talbot AW, Vallabhajosyula S, Whittle J, Williams KA Sr; Peer Review Committee Members. 2024 AHA/ACC/ACS/ASNC/HRS/SCA/SCCT/SCMR/SVM Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024 Nov 5;150(19):e351-e442. doi: 10.1161/CIR.0000000000001285. Epub 2024 Sep 24. PubMed 39316661 ↗

Individual participant data

Plan to share: Undecided — Individual participant data will not be shared. De-identified data may be made available upon reasonable request to the principal investigator, subject to institutional and ethics committee approval.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Sep 2026; primary completion for May 2029, 32 months later.

Of 391 non-industry interventional studies with no phase under Postoperative Complications, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 8 and three quarters within 44. This study's planned 32 months is above that.

Counting every sponsor, half of 395 studies reached it within 21 months; a quarter within 8 and three quarters within 45.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 5, 2026
First posted
Aug 19, 2026
StartEst.
Sep 1, 2026
Primary completionEst.
May 31, 2029
CompletionEst.
May 31, 2029
Last update
Aug 19, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 19, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07774689
Responsible party
Sponsor
First posted
Aug 19, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
May 31, 2029 (estimated)
Completion
May 31, 2029 (estimated)
Last update
Aug 19, 2026

Study contacts

Ji Hyun Lee, MD
Contact
jihyunlee310@snubh.org
82-31-787-7045
Ji Hyun Lee, MD
principal investigator · Seul National University Bundang Hospital

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.

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