European Heart Journal's AI Policy: ESC Rules for Cardiology's Top Journal

OUP publishes hundreds of journals. Its publication ethics page requires AI use to be disclosed in cover letters to editors and in the Methods or Acknowledgements section of manuscripts. The EHJ author instructions do not add a separate ESC rule on AI.

Check the author instructions at the time of submission, don't rely on last year's version.

EHJ publishes substantial AI research, echocardiographic analysis, cardiac MRI segmentation, CT calcium scoring algorithms. If your paper is about an AI tool for cardiac imaging, that AI is your research subject, described in standard Methods.

The manuscript preparation AI policy is separate. If you developed a deep learning model for left ventricular ejection fraction estimation and also used Claude to polish your Discussion, these require two distinct disclosures:

• Research AI: standard Methods (model architecture, training data, validation)

• Writing AI: the AI disclosure statement

Don't combine them. Reviewers need to distinguish AI as a research tool from AI as a writing tool.

For clinical trial reports (anticoagulation strategies, heart failure drugs, device therapies) we advise against using AI to interpret endpoints or draw clinical conclusions. The EHJ instructions do not set a separate rule for this, so treat it as a precaution rather than a journal requirement. Using AI to improve prose is the lower-risk use, and it still has to be disclosed.

ESC Clinical Practice Guidelines carry the highest sensitivity. These documents determine how millions of patients across Europe are treated. The formal policy doesn't separate guidelines from original research, but editorial scrutiny is much higher. Undisclosed AI in a guideline paper would damage credibility far beyond the individual authors.

A useful EHJ disclosure includes three elements: the tool and version, what was and wasn't done with AI, and a statement of author responsibility. The author instructions ask for AI use to be explained in full, so don't just name the tool and move on.

Original research example:

"During the preparation of this manuscript, the authors used ChatGPT (GPT-4, OpenAI) to improve the clarity of the Introduction and Discussion sections. All suggestions were reviewed by the corresponding author (A.B.) and senior biostatistician (C.D.). No AI tools were used in study design, data collection, statistical analysis, or interpretation of results. The authors take full responsibility for the content."

Imaging/AI research example:

"The deep learning model (EchoNet-LV) was developed using PyTorch and trained on the institutional echocardiographic dataset described in Methods. Separately, Claude (Claude 3.5, Anthropic) was used to edit the Results and Discussion for language clarity. These are entirely separate systems. All AI-suggested edits were reviewed by all authors."

Meta-analysis example:

"The authors used ChatGPT (GPT-4o, OpenAI) to improve readability of the Results section and check consistency of numerical values between tables and text. All outputs were verified against the original data extraction spreadsheets by two reviewers (E.F. and G.H.). The systematic search strategy, study selection, data extraction, quality assessment, and statistical analyses were performed entirely by the authors without AI assistance."

Notice what all three examples share: they name the specific tool and version, they draw a clear line between what AI did and didn't do, and they confirm author accountability. A vague "AI was used during manuscript preparation" does not meet the instruction to explain AI use in full.

EHJ follows COPE guidelines. The escalation path:

• Investigation: EHJ and OUP follow COPE guidance and say they will investigate alleged misconduct. The EHJ instructions say manuscripts may be screened, including with third-party services, for integrity issues such as inappropriate image alteration and papermill activity. They do not describe an AI-detection process.

• After acceptance, before publication: The instructions do not describe a specific step for undisclosed AI use. Contact the editorial office to add the disclosure as soon as you notice the omission.

• After publication: OUP's publication ethics page says that in proven cases of misconduct the action varies by journal and context, but could include retraction of published work or a correction or statement of concern. EHJ publishes a formal correction notice for any change to a published paper and subscribes to the COPE Retraction Guidelines.

• Institutional notification: OUP's publication ethics page lists notification of the author's local institution, superior, or ethics committee as a possible action in proven cases of misconduct.

Most omissions aren't malicious, authors didn't realize the policy applied to their use case, or they forgot to circle back and add the disclosure after using an AI tool midway through revisions. But "I didn't know" isn't a defense editorial boards accept in 2026. The policy is printed in the General Instructions, and checking those instructions is part of the submission process.

A 2025 study of 213 cardiovascular journals found that 170 (80%) had some AI policy, but only 3 of 17 high-impact journals actually mandated specific disclosure. None required standardized disclosure language. Here's how the top five compare based on their current author instructions:

Notable differences: EHJ's cover-letter-plus-body requirement is more explicit than most competitors. Circulation routes disclosure to Acknowledgments rather than Methods. JACC has a general AI policy but, as of the most recent study, doesn't mandate a specific disclosure section, though this may change as ACC updates its guidelines.

All five prohibit AI authorship. That rule is universal across the cardiology journal landscape.

EHJ's readership is global, and many authors aren't native English speakers. The ESC represents cardiologists across dozens of countries where English isn't the primary language. The AI policy does not forbid AI help with language, and translation is one of the AI uses the instructions say to disclose.

If English isn't your first language, you should feel comfortable using AI tools for grammar, sentence structure, and readability. That's what the policy permits. Just disclose it honestly. There's no stigma, it's the same function that professional language editing services have provided for decades.

The line to respect: don't use AI to generate scientific arguments, interpret data, or draft clinical conclusions. "Improving how I express my findings" is permitted. "Generating findings for me to express" is not.

Comply proactively if:

• You used any AI tool (ChatGPT, Grammarly, Copilot) during manuscript preparation

• The journal requires AI use disclosure in a cover letter and in the methods or acknowledgments

• Your institution has its own AI use policy that may be stricter

Less concerned if:

• You used AI only for grammar/spell checking (most journals exempt this)

• Your use was limited to literature search or reference management

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