AI ECG to quickly rule out heart attack (ROMIAE 2)

ROMIAE 2 Trial: Randomized Controlled Trial for Managing Suspicious Acute Myocardial Infarction in ED Using AI-ECG

Not applicable Interventional CHA University · NCT07027891

This study will test whether using an AI-read ECG can safely and quickly rule out heart attack in people who come to the emergency department with chest pain and suspected myocardial infarction.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment4670 (estimated)
Ages18 Years and up
SexAll
SponsorCHA University Academic / other
Locations12 sites (Seoul and 11 other locations)
Trial IDNCT07027891 on ClinicalTrials.gov

What this trial studies

This interventional study compares an AI-assisted electrocardiogram (AI-ECG) triage protocol with conventional triage for people presenting to the emergency department with chest pain and suspicion of acute myocardial infarction. Eligible participants present with chest pain suspicious for MI, while patients with STEMI, traumatic or clearly non-cardiac chest pain, recent revisit within one week, pneumothorax, cardiac arrest, or transfer already diagnosed with AMI are excluded. Patients randomized to the AI-ECG arm will have ECGs interpreted by an algorithm to guide early rule-out decisions, and the control arm will follow standard clinical protocols and testing. Outcomes focus on safety and efficacy measures for early triage such as missed MI, time to disposition, and resource use.

Who should consider this trial

Good fit: People who present to participating emergency departments with chest pain and a clinical suspicion of acute myocardial infarction, without an obvious STEMI or other exclusion criteria, are the ideal candidates.

Not a fit: Patients with an identified STEMI, clear non-cardiac chest pain, traumatic chest pain, recent revisit for the same symptoms, cardiac arrest, transfer already diagnosed with AMI, or pneumothorax are unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, the AI-ECG protocol could safely speed up ruling out heart attack, reduce unnecessary admissions and testing, and shorten emergency department stays.

How similar studies have performed: Early studies using AI-trained ECG algorithms for acute coronary syndrome and MI rule-out have shown promising results but require larger confirmatory trials like ROMIAE 2.

Eligibility criteria

Show full inclusion / exclusion criteria
Inclusion Criteria:

* chest pain
* suspicious of acute myocardial infarction

Exclusion Criteria:

* STEMI
* Revisit of same symptoms within 1 week
* traumatic chest pain
* Pneumothorax
* Transferred from other hospital diagnosed of AMI
* Cardiac arrest
* Chest pain of clearly non-cardiac etiology
* declined to participate in the study

Where this trial is running

Seoul and 11 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
Conditions Myocardial InfarctionChest Pain Rule Out Myocardial Infarctionchest pain, suspicious myocardial infarctionartificial intelligenceelectrocardiogramemergency departmentacute coronary syndromeAI/ML-enabled SaMd
Last reviewed 2026-06-13 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.