A system for determining a state or condition of a heart of a subject , comprising: a communications interface configured to wirelessly communicate with a monitoring device , which monitoring device comprises an electrocardiogram, ECG, sensor for measuring ECG data, an audio sensor for measuring audio data from said heart of said subject , and earpieces for listening to said audio data as said data is measured; and one or more computer processors of a computing device of a cloud system operatively coupled to said communications interface , wherein said one or more computer processors of the cloud system are individually or collectively programmed to: (i) receive said ECG data and said audio data wirelessly received by said communications interface from said monitoring device , (ii) use a trained algorithm to process said ECG data and said audio data to determine said state or condition of said heart of said subject , wherein the trained algorithm comprises a signal processing algorithm that uses a Q peak detection on said ECG data and an S1 envelope detection on said audio data to measure an electromechanical activation time, EMAT, from said ECG data and said audio data, and (iii) provide an output indicative of said state or condition of said heart of said subject on said computing device . a communications interface configured to wirelessly communicate with a monitoring device , which monitoring device comprises an electrocardiogram, ECG, sensor for measuring ECG data, an audio sensor for measuring audio data from said heart of said subject , and earpieces for listening to said audio data as said data is measured; and one or more computer processors of a computing device of a cloud system operatively coupled to said communications interface , wherein said one or more computer processors of the cloud system are individually or collectively programmed to: (i) receive said ECG data and said audio data wirelessly received by said communications interface from said monitoring device , (ii) use a trained algorithm to process said ECG data and said audio data to determine said state or condition of said heart of said subject , wherein the trained algorithm comprises a signal processing algorithm that uses a Q peak detection on said ECG data and an S1 envelope detection on said audio data to measure an electromechanical activation time, EMAT, from said ECG data and said audio data, and (iii) provide an output indicative of said state or condition of said heart of said subject on said computing device . (i) receive said ECG data and said audio data wirelessly received by said communications interface from said monitoring device , (ii) use a trained algorithm to process said ECG data and said audio data to determine said state or condition of said heart of said subject , wherein the trained algorithm comprises a signal processing algorithm that uses a Q peak detection on said ECG data and an S1 envelope detection on said audio data to measure an electromechanical activation time, EMAT, from said ECG data and said audio data, and (iii) provide an output indicative of said state or condition of said heart of said subject on said computing device . <EOS>