A Prospective, Multi-center, Randomized Clinical Trial to Evaluate the Detection of Atrial Fibrillation Using Artificial Intelligence-Enhanced Electrocardiography (SmartECG-AFrisk) Compared With Usual Care in Patients With Suspected Atrial Fibrillation: DEEP-AF

Participants receive routine care based on current clinical guidelines. Symptom-driven evaluation is performed by physicians, including at least one diagnostic test within 6 months such as a standard 12-lead ECG, Holter monitoring, or patch ECG. The choice and frequency of monitoring are determined by physician discretion, reflecting real-world practice patterns.

Participants undergo SmartECG-AFrisk analysis of baseline 12-lead ECGs recorded in sinus rhythm. The algorithm calculates an atrial fibrillation risk score, classifying participants as high-risk (score ≥50) or low-risk (\<50). Monitoring strategies are adapted accordingly: high-risk participants undergo targeted and potentially repeated ECG monitoring using 12-lead ECG, Holter, or patch ECG, while low-risk participants follow standard guideline-based care.