AI-ECG: A New Market For A Century-Old Test

InnovationHealthcareAI-ECG: A New Market For A Century-Old TestByDr. Tal Patalon, MD, LLB, MBA,Contributor.Forbes contributors publish independent expert analyses and insights. An experienced weaver of health, technology, ethics and spirituality.Follow AuthorJun 03, 2026, 02:44pm EDTIllustration by Anumana // Why bring AI into a test that has been around for a hundred years? | Each of my stories includes an original artwork. Clicking on them will take you to their websites. I am grateful for all the collaborators, sharing their work.©AnumanaWhy bring AI into a test that has been around for a hundred years?Cheap, fast, everywhere; about 300 million ECG tracings are produced worldwide each year on a machine that costs almost nothing to run. Now the tracings that haven't altered in a century are being interpreted by AI. And the change is real.Ask Viz.ai, Anumana and AliveCor whether their algorithms are ready to read the 12-lead ECG, and you get a close-to-unified answer: already cleared, already deployed at hundreds of US hospitals and clinics, already producing peer-reviewed evidence. Ask some clinicians, and the answer is different: not fully trusted, yet.The disagreement is not over whether AI can extract signal from a tracing. Both accept that it can. The disagreement is over what counts as proof, who decides when an algorithm has earned a place at the bedside and what to do in the gap between FDA clearance and national guidelines. I discussed this very question with three AI-ECG CEOs and a renowned ECG educator.Has the evidence arrived?Dr. Amal Mattu, who founded one of the field's first Emergency Cardiology Fellowships at the University of Maryland and has spent nearly 30 years training clinicians to read ECGs, sets an explicit bar. "AI needs to prove its worth in large studies, [then] it needs to be approved for clinical use, [then] it needs to be adopted into national guidelines before cardiology will routinely accept AI interpretations to influ...