NPPB and hydrops fetalis: <h4>Aims</h4>To develop and evaluate a deep learning model for immediate and accurate diagnosis of acute heart failure(HF) using standard 12-lead electrocardiogram(ECG) waveforms collected from a large cohort of patients.<h4>Methods and results</h4>We retrospectively analysed patients aged > 18 years who underwent transthoracic echocardiogram, <i>n</i>-terminal pro-B type natriuretic peptide (NT-proBNP) evaluation, and ECG within one week of clinical diagnosis at Samsung Medical from 1 February 2011 and 31 December 2022.