False arrhythmia alarms in intensive care units (ICUs) are a continuing problem despite considerable effort from industrial and academic algorithm developers. Of all life-threatening arrhythmias, ventricular tachycardia (VT) stands out as the most challenging arrhythmia to detect reliably. We introduce a new annotated VT alarm database, VTaC (Ventricular Tachycardia annotated alarms from ICUs) consisting of over 5,000 waveform recordings with VT alarms triggered by bedside monitors in the ICU. Each VT alarm waveform in the dataset has been labeled by at least two independent human expert annotators. The dataset encompasses data collected from ICUs in two major US hospitals and includes data from three leading bedside monitor manufacturers, providing a diverse and representative collection of alarm waveform data. Each waveform recording comprises at least two electrocardiogram (ECG) leads and one or more pulsatile waveforms, such as photoplethysmogram (PPG or PLETH) and arterial blood pressure (ABP) waveforms. We demonstrate the utility of this new benchmark dataset for the task of false arrhythmia alarm reduction, and present performance of multiple machine learning approaches, including conventional supervised machine learning, deep learning, semi-supervised learning, and generative approaches for the task of VT false alarm reduction.

Clinical decision support systems (CDSSs) have been widely utilized to support the decisions made by cardiologists when detecting and classifying arrhythmia from electrocardiograms. However, forming a CDSS for the arrhythmia classification task is challenging due to the varying lengths of arrhythmias. Although the onset time of arrhythmia varies, previously developed methods have not considered such conditions. Thus, we propose a framework that consists of (i) local and global extraction and (ii) local-global information fusion with attention to enable arrhythmia detection and classification within a constrained input length. The framework's performance was evaluated in terms of 10-class and 4-class arrhythmia detection, focusing on identifying the onset and ending point of arrhythmia episodes and their duration using the MIT-BIH arrhythmia database (MITDB) and the MIT-BIH atrial fibrillation database (AFDB). Duration, episode, and Dice score performances resulted in overall F1-scores of 96.45%, 82.05%, and 96.31% on the MITDB and 97.57%, 98.31%, and 97.45% on the AFDB, respectively. The results demonstrated statistically superior performance compared to those of the benchmark models. To assess the generalization capability of the proposed method, an MITDB-trained model and MIT-BIH malignant ventricular arrhythmia database-trained model were tested AFDB and MITDB, respectively. Superior performance was attained compared with that of a state-of-the-art model. The proposed method effectively captures both local and global information and dynamics without significant information loss. Consequently, arrhythmias can be detected with greater accuracy, and their occurrence times can be precisely determined, enabling the clinical field to develop more accurate treatment plans based on the proposed method.

Twelve-lead electrocardiograms (ECGs) are the clinical gold standard for cardiac diagnosis, providing comprehensive spatial coverage of the heart necessary to detect conditions such as myocardial infarction (MI). However, their lack of portability limits continuous and large-scale use. Three-lead ECG systems are widely used in wearable devices due to their simplicity and mobility, but they often fail to capture pathologies in unmeasured regions. To address this, we propose WearECG, a Variational Autoencoder (VAE) method that reconstructs twelve-lead ECGs from three leads: II, V1, and V5. Our model includes architectural improvements to better capture temporal and spatial dependencies in ECG signals. We evaluate generation quality using MSE, MAE, and Frechet Inception Distance (FID), and assess clinical validity via a Turing test with expert cardiologists. To further validate diagnostic utility, we fine-tune ECGFounder, a large-scale pretrained ECG model, on a multi-label classification task involving over 40 cardiac conditions, including six different myocardial infarction locations, using both real and generated signals. Experiments on the MIMIC dataset show that our method produces physiologically realistic and diagnostically informative signals, with robust performance in downstream tasks. This work demonstrates the potential of generative modeling for ECG reconstruction and its implications for scalable, low-cost cardiac screening.

Arrhythmia is a common cardiac condition that can precipitate severe complications without timely intervention. While continuous monitoring is essential for timely diagnosis, conventional approaches such as electrocardiogram and wearable devices are constrained by their reliance on specialized medical expertise and patient discomfort from their contact nature. Existing contactless monitoring, primarily designed for healthy subjects, face significant challenges when analyzing reflected signals from arrhythmia patients due to disrupted spatial stability and temporal consistency. In this paper, we introduce mCardiacDx, a radar-driven contactless system that accurately analyzes reflected signals and reconstructs heart pulse waveforms for arrhythmia monitoring and diagnosis. The key contributions of our work include a novel precise target localization (PTL) technique that locates reflected signals despite spatial disruptions, and an encoder-decoder model that transforms these signals into HPWs, addressing temporal inconsistencies. Our evaluation on a large dataset of healthy subjects and arrhythmia patients shows that both mCardiacDx and PTL outperform state-of-the-art approach in arrhythmia monitoring and diagnosis, also demonstrating improved performance in healthy subjects.

Cardiac arrhythmias are a leading cause of life-threatening cardiac events, highlighting the urgent need for accurate and timely detection. Electrocardiography (ECG) remains the clinical gold standard for arrhythmia diagnosis; however, manual interpretation is time-consuming, dependent on clinical expertise, and prone to human error. Although deep learning has advanced automated ECG analysis, many existing models abstract away the signal's intrinsic temporal and morphological features, lack interpretability, and are computationally intensive-hindering their deployment on resource-constrained platforms. In this work, we propose two novel lightweight 1D convolutional neural networks, ArrhythmiNet V1 and V2, optimized for efficient, real-time arrhythmia classification on edge devices. Inspired by MobileNet's depthwise separable convolutional design, these models maintain memory footprints of just 302.18 KB and 157.76 KB, respectively, while achieving classification accuracies of 0.99 (V1) and 0.98 (V2) on the MIT-BIH Arrhythmia Dataset across five classes: Normal Sinus Rhythm, Left Bundle Branch Block, Right Bundle Branch Block, Atrial Premature Contraction, and Premature Ventricular Contraction. In order to ensure clinical transparency and relevance, we integrate Shapley Additive Explanations and Gradient-weighted Class Activation Mapping, enabling both local and global interpretability. These techniques highlight physiologically meaningful patterns such as the QRS complex and T-wave that contribute to the model's predictions. We also discuss performance-efficiency trade-offs and address current limitations related to dataset diversity and generalizability. Overall, our findings demonstrate the feasibility of combining interpretability, predictive accuracy, and computational efficiency in practical, wearable, and embedded ECG monitoring systems.

In Romania, cardiovascular problems are the leading cause of death, accounting for nearly one-third of annual fatalities. The severity of this situation calls for innovative diagnosis method for cardiovascular diseases. This article aims to explore efficient, light-weight and rapid methods for arrhythmia diagnosis, in resource-constrained healthcare settings. Due to the lack of Romanian public medical data, we trained our systems using international public datasets, having in mind that the ECG signals are the same regardless the patients' nationality. Within this purpose, we combined multiple datasets, usually used in the field of arrhythmias classification: PTB-XL electrocardiography dataset , PTB Diagnostic ECG Database, China 12-Lead ECG Challenge Database, Georgia 12-Lead ECG Challenge Database, and St. Petersburg INCART 12-lead Arrhythmia Database. For the input data, we employed ECG signal processing methods, specifically a variant of the Pan-Tompkins algorithm, useful in arrhythmia classification because it provides a robust and efficient method for detecting QRS complexes in ECG signals. Additionally, we used machine learning techniques, widely used for the task of classification, including convolutional neural networks (1D CNNs, 2D CNNs, ResNet) and Vision Transformers (ViTs). The systems were evaluated in terms of accuracy and F1 score. We annalysed our dataset from two perspectives. First, we fed the systems with the ECG signals and the GRU-based 1D CNN model achieved the highest accuracy of 93.4% among all the tested architectures. Secondly, we transformed ECG signals into images and the CNN2D model achieved an accuracy of 92.16%.

False arrhythmia alarms in intensive care units (ICUs) are a continuing problem despite considerable effort from industrial and academic algorithm developers. Of all life-threatening arrhythmias, ventricular tachycardia (VT) stands out as the most challenging arrhythmia to detect reliably. We introduce a new annotated VT alarm database, VTaC (Ventricular Tachycardia annotated alarms from ICUs) consisting of over 5,000 waveform recordings with VT alarms triggered by bedside monitors in the ICU. Each VT alarm waveform in the dataset has been labeled by at least two independent human expert annotators. The dataset encompasses data collected from ICUs in two major US hospitals and includes data from three leading bedside monitor manufacturers, providing a diverse and representative collection of alarm waveform data.

In this paper, we present a high-performance, compact electrocardiogram (ECG)-based system for automatic classification of arrhythmias, integrating machine learning approaches to achieve robust cardiac diagnostics. Our method combines a compact artificial neural network with feature enhancement techniques, including mathematical transformations, signal analysis and data extraction algorithms, to capture both morphological and time-frequency features from ECG signals. A novel aspect of this work is the addition of 17 newly engineered features, which complement the algorithm's capability to extract significant data and physiological patterns from the ECG signal. This combination enables the classifier to detect multiple arrhythmia types, such as atrial fibrillation, sinus tachycardia, ventricular flutter, and other common arrhythmic disorders. The system achieves an accuracy of 97.36% on the MIT-BIH arrhythmia database, using a lower complexity compared to state-of-the-art models. This compact tool shows potential for clinical deployment, as well as adaptation for portable devices in long-term cardiac health monitoring applications.

The rapid advancements in Artificial Intelligence, specifically Machine Learning (ML) and Deep Learning (DL), have opened new prospects in medical sciences for improved diagnosis, prognosis, and treatment of severe health conditions. This paper focuses on the development of an ML model with high predictive accuracy to classify arrhythmic electrocardiogram (ECG) signals. The ECG signals datasets utilized in this study were sourced from the PhysioNet and MIT-BIH databases. The research commenced with binary classification, where an optimized Bidirectional Long Short-Term Memory (Bi-LSTM) model yielded excellent results in differentiating normal and atrial fibrillation signals. A pivotal aspect of this research was a survey among medical professionals, which not only validated the practicality of AI-based ECG classifiers but also identified areas for improvement, including accuracy and the inclusion of more arrhythmia types. These insights drove the development of an advanced Convolutional Neural Network (CNN) system capable of classifying five different types of ECG signals with better accuracy and precision. The CNN model's robust performance was ensured through rigorous stratified 5-fold cross validation. A web portal was also developed to demonstrate real-world utility, offering access to the trained model for real-time classification. This study highlights the potential applications of such models in remote health monitoring, predictive healthcare, assistive diagnostic tools, and simulated environments for educational training and interdisciplinary collaboration between data scientists and medical personnel.

Large language models (LLMs) have demonstrated remarkable progress in healthcare. However, a significant gap remains regarding LLMs' professionalism in domain-specific clinical practices, limiting their application in real-world diagnostics. In this work, we introduce ZODIAC, an LLM-powered framework with cardiologist-level professionalism designed to engage LLMs in cardiological diagnostics. ZODIAC assists cardiologists by extracting clinically relevant characteristics from patient data, detecting significant arrhythmias, and generating preliminary reports for the review and refinement by cardiologists. To achieve cardiologist-level professionalism, ZODIAC is built on a multi-agent collaboration framework, enabling the processing of patient data across multiple modalities. Each LLM agent is fine-tuned using real-world patient data adjudicated by cardiologists, reinforcing the model's professionalism. ZODIAC undergoes rigorous clinical validation with independent cardiologists, evaluated across eight metrics that measure clinical effectiveness and address security concerns. Results show that ZODIAC outperforms industry-leading models, including OpenAI's GPT-4o, Meta's Llama-3.1-405B, and Google's Gemini-pro, as well as medical-specialist LLMs like Microsoft's BioGPT. ZODIAC demonstrates the transformative potential of specialized LLMs in healthcare by delivering domain-specific solutions that meet the stringent demands of medical practice. Notably, ZODIAC has been successfully integrated into electrocardiography (ECG) devices, exemplifying the growing trend of embedding LLMs into Software-as-Medical-Device (SaMD).