MVMTnet: A Multi-variate Multi-modal Transformer for Multi-class Classification of Cardiac Irregularities Using ECG Waveforms and Clinical Notes

Deep learning provides an excellent avenue for optimizing diagnosis and patient monitoring for clinical-based applications, which can critically enhance the response time to the onset of various conditions. For cardiovascular disease, one such condition where the rising number of patients increasingly outweighs the availability of medical resources in different parts of the world, a core challenge is the automated classification of various cardiac abnormalities. Existing deep learning approaches have largely been limited to detecting the existence of an irregularity, as in binary classification, which has been achieved using networks such as CNNs and RNN/LSTMs. The next step is to accurately perform multi-class classification and determine the specific condition(s) from the inherently noisy multivariate waveform, which is a difficult task that could benefit from (1) a more powerful sequential network, and (2) the integration of clinical notes, which provide valuable semantic and clinical context from human doctors. Recently, Transformers have emerged as the state-of-the-art architecture for forecasting and prediction using time-series data, with their multi-headed attention mechanism, and ability to process whole sequences and learn both long and short-range dependencies. The proposed novel multi-modal Transformer architecture would be able to accurately perform this task while demonstrating the cross-domain effectiveness of Transformers, establishing a method for incorporating multiple data modalities within a Transformer for classification tasks, and laying the groundwork for automating real-time patient condition monitoring in clinical and ER settings. Deep learning has revolutionized medical signal processing and is able to outperform traditional Electrocardiogram (ECG) analysis for cardiac diagnostics (Smith et al., 2019). ECG waveforms, which depict the electrical activity of the heart, are a time series representation of the heart's voltage. Different ECG machines can have multiple leads, each representing different directions of cardiac activation (Park et al., 2022).