# Estimating ECG Intervals from Lead-I Alone: External Validation of Supervised Models

arXiv: https://arxiv.org/abs/2408.15272 · HTML: https://mlsanity.com/paper/2408.15272/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 7 of its 40 references that are in the map.
- First posted on arXiv 12 Aug 2024.

## Builds on (most cited first, 7 of 7)

- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [CLOCS: Contrastive Learning of Cardiac Signals Across Space, Time, and Patients](https://mlsanity.com/paper/2005.13249/) (2020)
- [Automatic diagnosis of the 12-lead ECG using a deep neural network](https://mlsanity.com/paper/1904.01949/) (2019)
- [Deep Learning for ECG Analysis: Benchmarks and Insights from PTB-XL](https://mlsanity.com/paper/2004.13701/) (2020)
- [Self-supervised representation learning from 12-lead ECG data](https://mlsanity.com/paper/2103.12676/) (2021)
- [Patient Contrastive Learning: a Performant, Expressive, and Practical Approach to ECG Modeling](https://mlsanity.com/paper/2104.04569/) (2021)
- [Detecting QT prolongation From a Single-lead ECG With Deep Learning](https://mlsanity.com/paper/2401.05378/) (2023)

## Built on by (most cited first, 1 of 1)

- [AICRN: Attention-Integrated Convolutional Residual Network for Interpretable Electrocardiogram Analysis](https://mlsanity.com/paper/2508.12162/) (2025)

## Abstract (arXiv)

The diagnosis, prognosis, and treatment of a number of cardiovascular disorders rely on ECG interval measurements, including the PR, QRS, and QT intervals. These quantities are measured from the 12-lead ECG, either manually or using automated algorithms, which are readily available in clinical settings. A number of wearable devices, however, can acquire the lead-I ECG in an outpatient setting, thereby raising the potential for out-of-hospital monitoring for disorders that involve clinically significant changes in ECG intervals. In this work, we therefore developed a series of deep learning models for estimating the PR, QRS, and QT intervals using lead-I ECG. From a corpus of 4.2 million ECGs from patients at the Massachusetts General Hospital, we train and validate each of the models. At internal holdout validation, we achieve mean absolute errors (MAE) of 6.3 ms for QRS durations and 11.9 ms for QT intervals, and an MAE of 9.2 ms for estimating PR intervals. Moreover, as a well-defined P-wave does not always exist in ECG tracings - for example, when there is atrial fibrillation - we trained a model that can identify when there is a P-wave, and consequently, a measurable PR interval. We validate our models on three large external healthcare datasets without any finetuning or retraining - 3.2 million ECG from the Brigham and Womens Hospital, 668 thousand from MIMIC-IV, and 20 thousand from PTB-XL - and achieve similar performance. Also, our models significantly outperform two publicly available baseline algorithms. This work demonstrates that ECG intervals can be tracked from only lead-I ECG using deep learning, and highlights the potential for out-of-hospital applications.