12-lead ECGs with high sampling frequency are the clinical gold standard for arrhythmia detection, but their short-term, spot-check nature often misses intermittent events. Wearable ECGs enable long-term monitoring but suffer from irregular, lower sampling frequencies due to battery constraints, making morphology analysis challenging. We present an end-to-end classification pipeline to address these issues. We train a latent ODE to model continuous ECG waveforms and create robust feature vectors from high-frequency single-channel signals. We construct three latent vectors per waveform via downsampling the initial 360 Hz ECG to 90 Hz and 45 Hz. We then use a gradient boosted tree to classify these vectors and test robustness across frequencies. Performance shows minimal degradation, with macro-averaged AUC-ROC values of 0.984, 0.978, and 0.976 at 360 Hz, 90 Hz, and 45 Hz, respectively, suggesting a way to sidestep the trade-off between signal fidelity and battery life. This enables smaller wearables, promoting long-term monitoring of cardiac health.

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.

Pediatric arrhythmias are a major risk factor for disability and sudden cardiac death, yet their automated classification remains challenging due to class imbalance, few-shot categories, and complex signal characteristics, which severely limit the efficiency and reliability of early screening and clinical intervention. To address this problem, we propose a multimodal end-to-end deep learning framework that combines dual-branch convolutional encoders for ECG and IEGM, semantic attention for cross-modal feature alignment, and a lightweight Transformer encoder for global dependency modeling. In addition, we introduce a new contrastive loss fucntion named Adaptive Global Class-Aware Contrastive Loss (AGCACL) to enhance intra-class compactness and inter-class separability through class prototypes and a global similarity matrix. To the best of our knowledge, this is the first systematic study based on the Leipzig Heart Center pediatric/congenital ECG+IEGM dataset, for which we also provide a complete and reproducible preprocessing pipeline. Experimental results demonstrate that the proposed method achieves the overall best performance on this dataset, including 97.76\% Top-1 Accuracy, 94.08\% Macro Precision, 91.97\% Macro Recall, 92.97\% Macro F1, and 92.36\% Macro F2, with improvements of +13.64, +15.96, +19.82, and +19.44 percentage points over the strongest baseline in Macro Precision/Recall/F1/F2, respectively. These findings indicate that the framework significantly improves the detectability and robustness for minority arrhythmia classes, offering potential clinical value for rhythm screening, pre-procedural assessment, and postoperative follow-up in pediatric and congenital heart disease populations.

Abstract--Objective: Electrocardiograms (ECGs) play a crucial role in diagnosing heart conditions; however, the effectiveness of artificial intelligence (AI)-based ECG analysis is often hindered by the limited availability of labeled data. Self-supervised learning (SSL) can address this by leveraging large-scale unlabeled data. We introduce PhysioCLR (Physiology-aware Contrastive Learning Representation for ECG), a physiology-aware contrastive learning framework that incorporates domain-specific priors to enhance the generalizability and clinical relevance of ECG-based arrhythmia classification. Methods: During pre-training, PhysioCLR learns to bring together embeddings of samples that share similar clinically relevant features while pushing apart those that are dissimilar . Additionally, we introduce ECGspecific augmentations that preserve the ECG category post-augmentation and propose a hybrid loss function to further refine the quality of learned representations. Results: We evaluate PhysioCLR on two public ECG datasets, Chapman and Georgia, for multilabel ECG diagnoses, as well as a private ICU dataset labeled for binary classification. Across the Chapman, Georgia, and private cohorts, PhysioCLR boosts the mean AUROC by 12% relative to the strongest baseline, underscoring its robust cross-dataset generalization. This work was supported in part by the Natural Sciences and Engineering Research Council of Canada (NSERC); the New Frontiers in Research Fund (NFRF) through the Social Sciences and Humanities Research Council (SSHRC); and the V ector Institute. Sophia Mannina is supported in part by the Social Sciences and Humanities Research Council. Stephanie Sibley is supported in part by the Canadian Institutes of Health Research (CIHR). David Maslove is supported in part by the Southeastern Ontario Academic Medical Association (SEAMO).

--We propose a deep neural architecture that performs uncertainty-aware multi-view classification of arrhythmia from ECG. Our method learns two different views (1D and 2D) of single-lead ECG to capture different types of information. We use a fusion technique to reduce the conflict between the different views caused by noise and artifacts in ECG data, thus incorporating uncertainty to obtain stronger final predictions. Our framework contains the following three modules (1) a time-series module to learn the morphological features from ECG; (2) an image-space learning module to learn the spatiotemporal features; and (3) the uncertainty-aware fusion module to fuse the information from the two different views. Experimental results on two real-world datasets demonstrate that our framework not only improves the performance on arrhythmia classification compared to the state-of-the-art but also shows better robustness to noise and artifacts present in ECG.

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%.

The variability in ECG readings influenced by individual patient characteristics has posed a considerable challenge to adopting automated ECG analysis in clinical settings. A novel feature fusion technique termed SACC (Self Attentive Canonical Correlation) was proposed to address this. This technique is combined with DPN (Dual Pathway Network) and depth-wise separable convolution to create a robust, interpretable, and fast end-to-end arrhythmia classification model named rECGnition_v2.0 (robust ECG abnormality detection). This study uses MIT-BIH, INCARTDB and EDB dataset to evaluate the efficiency of rECGnition_v2.0 for various classes of arrhythmias. To investigate the influence of constituting model components, various ablation studies were performed, i.e. simple concatenation, CCA and proposed SACC were compared, while the importance of global and local ECG features were tested using DPN rECGnition_v2.0 model and vice versa. It was also benchmarked with state-of-the-art CNN models for overall accuracy vs model parameters, FLOPs, memory requirements, and prediction time. Furthermore, the inner working of the model was interpreted by comparing the activation locations in ECG before and after the SACC layer. rECGnition_v2.0 showed a remarkable accuracy of 98.07% and an F1-score of 98.05% for classifying ten distinct classes of arrhythmia with just 82.7M FLOPs per sample, thereby going beyond the performance metrics of current state-of-the-art (SOTA) models by utilizing MIT-BIH Arrhythmia dataset. Similarly, on INCARTDB and EDB datasets, excellent F1-scores of 98.01% and 96.21% respectively was achieved for AAMI classification. The compact architectural footprint of the rECGnition_v2.0, characterized by its lesser trainable parameters and diminished computational demands, unfurled several advantages including interpretability and scalability.

Machine learning has transformed the classification of biomedical signals such as electrocardiograms (ECGs). Advances in deep learning, particularly convolutional neural networks (CNNs), enable automatic feature extraction, raising the question: Can combining time- and frequency-domain attributes enhance classification accuracy? To explore this, we evaluated three ECG classification tasks: (1) arrhythmia classification, (2) identity recognition, and (3) apnea detection. We initially tested three methods: (i) 2-D spectrogram-based frequency-time classification (SPECT), (ii) time-domain classification using a 1-D CNN (CNN1D), and (iii) frequency-domain classification using a Fourier transform-based CNN (FFT1D). Performance was validated using K-fold cross-validation. Among these, CNN1D (time only) performed best, followed by SPECT (time-frequency) and FFT1D (frequency only). Surprisingly, SPECT, which integrates time- and frequency-domain features, performed worse than CNN1D, suggesting a need for a more effective time and frequency fusion approach. To address this, we tested the recently proposed Fourier Analysis Network (FAN), which combines time- and frequency-domain features. However, FAN performed comparably to CNN1D, excelling in some tasks while underperforming in others. To enhance this approach, we developed the Convolutional Fourier Analysis Network (CFAN), which integrates FAN with CNN. CFAN outperformed all previous methods across all classification tasks. These findings underscore the advantages of combining time- and frequency-domain features, demonstrating CFAN's potential as a powerful and versatile solution for ECG classification and broader biomedical signal analysis

The urgent need to promptly detect cardiac disorders from 12-lead Electrocardiograms using limited computations is motivated by the heart's fast and complex electrical activity and restricted computational power of portable devices. Timely and precise diagnoses are crucial since delays might significantly impact patient health outcomes. This research presents a novel deep-learning architecture that aims to diagnose heart abnormalities quickly and accurately. We devised a new activation function called aSoftMax, designed to improve the visibility of ECG deflections. The proposed activation function is used with Convolutional Neural Network architecture to includes kernel weight sharing across the ECG's various leads. This innovative method thoroughly generalizes the global 12-lead ECG features and minimizes the model's complexity by decreasing the trainable parameters. aSoftMax, combined with enhanced CNN architecture yielded AmpliNetECG12, we obtain exceptional accuracy of 84% in diagnosing cardiac disorders. AmpliNetECG12 shows outstanding prediction ability when used with the CPSC2018 dataset for arrhythmia classification. The model attains an F1-score of 80.71% and a ROC-AUC score of 96.00%, with 280,000 trainable parameters which signifies the lightweight yet efficient nature of AmpliNetECG12. The stochastic characteristics of aSoftMax, a fundamental element of AmpliNetECG12, improve prediction accuracy and also increasse the model's interpretability. This feature enhances comprehension of important ECG segments in different forms of arrhythmias, establishing a new standard of explainable architecture for cardiac disorder classification.