RCEM Learning September 2025
Sep 19, 2025
Chris, clinical co-presenter who explains ESC atrial fibrillation guidance with practical ED approaches. Becky, clinician focusing on stroke prevention, anticoagulation and acute AF management. Dave, emergency clinician offering pragmatic evidence review. Andy, EM clinician critiquing recent literature. They discuss AI vs doctors for cath lab activations, ESC AF guideline practicalities, and as-needed albuterol–budesonide for asthma.
AI Snips
Chapters
Transcript
Episode notes
AI Greatly Improves OMI Detection
- The Queen of Hearts AI outperformed emergency physicians and cardiologists, achieving ~89% overall accuracy versus ~65% for humans on STEMI-equivalent and mimic ECGs.
- Study used 18 ECGs from Steve Smith's database and compared clinicians' cath lab activation decisions to AI, benchmarked against angio/troponin/echo outcomes.
Prospectively Validate ECG AI First
- Validate AI prospectively in real-world settings before routine clinical use to avoid premature adoption based on cross-sectional data.
- Authors and speakers recommend stepwise non-interventional prospective studies then interventional trials to confirm benefits and safety.
AI Will Change ECG Training Priorities
- Integrating AI could shift ECG education away from memorising complex morphologies toward higher-value clinical skills.
- Steve Smith and others suggest focusing training on interpretation context and decision-making rather than exhaustive pattern recall.