In the process of patient diagnosis, non-invasive measurements are widely used due to their low risks and quick results. Electrocardiogram (ECG), as a non-invasive method to collect heart activities, is used to diagnose cardiac conditions. Analyzing the ECG typically requires domain expertise, which is a roadblock to applying artificial intelligence (AI) for healthcare. Through advances in self-supervised learning and foundation models, AI systems can now acquire and leverage domain knowledge without relying solely on human expertise. However, there is a lack of comprehensive analyses over the foundation models' performance on ECG. This study aims to answer the research question: "Are Foundation Models Useful for ECG Analysis?" To address it, we evaluate language/general time-series/ECG foundation models in comparison with time-series deep learning models. The experimental results show that general time-series/ECG foundation models achieve a top performance rate of 80%, indicating their effectiveness in ECG analysis. In-depth analyses and insights are provided along with comprehensive experimental results. This study highlights the limitations and potential of foundation models in advancing physiological waveform analysis. The data and code for this benchmark are publicly available at https://github.com/yuhaoxu99/ECGMultitasks-Benchmark.

Electrocardiogram is a useful diagnostic signal that can detect cardiac abnormalities by measuring the electrical activity generated by the heart. Due to its rapid, non-invasive, and richly informative characteristics, ECG has many emerging applications. In this paper, we study novel deep learning technologies to effectively manage and analyse ECG data, with the aim of building a diagnostic model, accurately and quickly, that can substantially reduce the burden on medical workers. Unlike the existing ECG models that exhibit a high misdiagnosis rate, our deep learning approaches can automatically extract the features of ECG data through end-to-end training. Specifically, we first devise EfficientECG, an accurate and lightweight classification model for ECG analysis based on the existing EfficientNet model, which can effectively handle high-frequency long-sequence ECG data with various leading types. On top of that, we next propose a cross-attention-based feature fusion model of EfficientECG for analysing multi-lead ECG data with multiple features (e.g., gender and age). Our evaluations on representative ECG datasets validate the superiority of our model against state-of-the-art works in terms of high precision, multi-feature fusion, and lightweights.

Despite the rapid advancements of electrocardiogram (ECG) signal diagnosis and analysis methods through deep learning, two major hurdles still limit their clinical adoption: the lack of versatility in processing ECG signals with diverse configurations, and the inadequate detection of risk signals due to sample imbalances. Addressing these challenges, we introduce VersAtile and Risk-Sensitive cardiac diagnosis (VARS), an innovative approach that employs a graph-based representation to uniformly model heterogeneous ECG signals. VARS stands out by transforming ECG signals into versatile graph structures that capture critical diagnostic features, irrespective of signal diversity in the lead count, sampling frequency, and duration. This graph-centric formulation also enhances diagnostic sensitivity, enabling precise localization and identification of abnormal ECG patterns that often elude standard analysis methods. To facilitate representation transformation, our approach integrates denoising reconstruction with contrastive learning to preserve raw ECG information while highlighting pathognomonic patterns. We rigorously evaluate the efficacy of VARS on three distinct ECG datasets, encompassing a range of structural variations. The results demonstrate that VARS not only consistently surpasses existing state-of-the-art models across all these datasets but also exhibits substantial improvement in identifying risk signals. Additionally, VARS offers interpretability by pinpointing the exact waveforms that lead to specific model outputs, thereby assisting clinicians in making informed decisions. These findings suggest that our VARS will likely emerge as an invaluable tool for comprehensive cardiac health assessment.

Interpreting and communicating electrocardiogram (ECG) findings are crucial yet challenging tasks in cardiovascular diagnosis, traditionally requiring significant expertise and precise clinical communication. This paper introduces Cardi-GPT, an advanced expert system designed to streamline ECG interpretation and enhance clinical communication through deep learning and natural language interaction. Cardi-GPT employs a 16-residual-block convolutional neural network (CNN) to process 12-lead ECG data, achieving a weighted accuracy of 0.6194 across 24 cardiac conditions. A novel fuzzification layer converts complex numerical outputs into clinically meaningful linguistic categories, while an integrated chatbot interface facilitates intuitive exploration of diagnostic insights and seamless communication between healthcare providers. The system was evaluated on a diverse dataset spanning six hospitals across four countries, demonstrating superior performance compared to baseline models. Additionally, Cardi-GPT achieved an impressive overall response quality score of 73\%, assessed using a comprehensive evaluation framework that measures coverage, grounding, and coherence. By bridging the gap between intricate ECG data interpretation and actionable clinical insights, Cardi-GPT represents a transformative innovation in cardiovascular healthcare, promising to improve diagnostic accuracy, clinical workflows, and patient outcomes across diverse medical settings.

Human activity recognition is critical for applications such as early intervention and health analytics. Traditional activity recognition relies on inertial measurement units (IMUs), which are resource intensive and require calibration. Although electrocardiogram (ECG)-based methods have been explored, these have typically served as supplements to IMUs or have been limited to broad categorical classification such as fall detection or active vs. inactive in daily activities. In this paper, we advance the field by demonstrating, for the first time, robust recognition of activity only with ECG in six distinct activities, which is beyond the scope of previous work. We design and evaluate three new deep learning models, including a CNN classifier with Squeeze-and-Excitation blocks for channel-wise feature recalibration, a ResNet classifier with dilated convolutions for multiscale temporal dependency capture, and a novel CNNTransformer hybrid combining convolutional feature extraction with attention mechanisms for long-range temporal relationship modeling. Tested on data from 54 subjects for six activities, all three models achieve over 94% accuracy for seen subjects, while CNNTransformer hybrid reaching the best accuracy of 72% for unseen subjects, a result that can be further improved by increasing the training population. This study demonstrates the first successful ECG-only activity classification in multiple physical activities, offering significant potential for developing next-generation wearables capable of simultaneous cardiac monitoring and activity recognition without additional motion sensors.

-- Cardiovascular diseases (CVDs) remain a leading cause of mortality worldwide, underscoring the importance of accurate and scalable diagnostic systems. Electrocardiogram (ECG) analysis is central to detecting cardiac abnormalities, yet challenges such as noise, class imbalance, and dataset heterogeneity limit current methods. To address these issues, we propose Foun-dationalECGNet, a foundational framework for automated ECG classification. The model integrates a dual-stage de-noising by Morlet and Daubechies wavelets transformation, Convolutional Block Attention Module (CBAM), Graph Attention Networks (GAT), and Time Series Transformers (TST) to jointly capture spatial and temporal dependencies in multi-channel ECG signals. FoundationalECGNet first distinguishes between Normal and Abnormal ECG signals, and then classifies the Abnormal signals into one of five cardiac conditions: Arrhythmias, Conduction Disorders, Myocardial Infarction, QT Abnormalities, or Hypertrophy. Across multiple datasets, the model achieves a 99% F1-score for Normal vs. Abnormal classification and shows state-of-the-art performance in multi-class disease detection, including a 99% F1-score for Conduction Disorders and Hypertrophy, as well as a 98.9% F1-score for Arrhythmias. Additionally, the model provides risk level estimations to facilitate clinical decision-making. In conclusion, FoundationalECGNet represents a scalable, interpretable, and generalizable solution for automated ECG analysis, with the potential to improve diagnostic precision and patient outcomes in healthcare settings. ARDIOV ASCULAR diseases (CVDs) are the leading cause of death worldwide, leading to approximately 17.9 million deaths each year [45].

-- The increasing availability of publicly shared electrocardiogram (ECG) data raises critical privacy concerns, as its biometric properties make individuals vulnerable to linkage attacks. Unlike prior studies that assume idealized adversarial capabilities, we evaluate ECG privacy risks under realistic conditions where attackers operate with partial knowledge. Using data from 109 participants across diverse real-world datasets, our approach achieves 85% accuracy in re-identifying individuals in public datasets while maintaining a 14.2% overall misclassification rate at an optimal confidence threshold, with 15.6% of unknown individuals misclassified as known and 12.8% of known individuals misclassified as unknown. These results highlight the inadequacy of simple anonymization techniques in preventing re-identification, demonstrating that even limited adversarial knowledge enables effective identity linkage. Our findings underscore the urgent need for privacy-preserving strategies, such as differential privacy, access control, and encrypted computation, to mitigate re-identification risks while ensuring the utility of shared biosignal data in healthcare applications. Electrocardiograms (ECG) capture the heart's electrical activity, serving as a key diagnostic tool for conditions like heart failure and arrhythmias [1], [2].

Cardiovascular diseases (CVDs) are the leading cause of mortality worldwide, accounting for over 30% of global deaths according to the World Health Organization (WHO). Importantly, one-third of these deaths are preventable with timely and accurate diagnosis. The electrocardiogram (ECG), a non-invasive method for recording the electrical activity of the heart, is crucial for diagnosing CVDs. However, privacy concerns surrounding the use of patient ECG data in research have spurred interest in synthetic data, which preserves the statistical properties of real data without compromising patient confidentiality. This study explores the potential of synthetic ECG data for training deep learning models from regression to classification tasks and evaluates the feasibility of transfer learning to enhance classification performance on real ECG data. We experimented with popular deep learning models to predict four key cardiac parameters, namely, Heart Rate (HR), PR interval, QT interval, and QRS complex-using separate regression models. Subsequently, we leveraged these regression models for transfer learning to perform 5-class ECG signal classification. Our experiments systematically investigate whether transfer learning from regression to classification is viable, enabling better utilization of diverse open-access and synthetic ECG datasets. Our findings demonstrate that transfer learning from regression to classification improves classification performance, highlighting its potential to maximize the utility of available data and advance deep learning applications in this domain.

With the proliferation of wireless electrocardiogram (ECG) systems for health monitoring and authentication, protecting signal integrity against tampering is becoming increasingly important. This paper analyzes the performance of CNN, ResNet, and hybrid Transformer-CNN models for tamper detection. It also evaluates the performance of a Siamese network for ECG based identity verification. Six tampering strategies, including structured segment substitutions and random insertions, are emulated to mimic real world attacks. The one-dimensional ECG signals are transformed into a two dimensional representation in the time frequency domain using the continuous wavelet transform (CWT). The models are trained and evaluated using ECG data from 54 subjects recorded in four sessions 2019 to 2025 outside of clinical settings while the subjects performed seven different daily activities. Experimental results show that in highly fragmented manipulation scenarios, CNN, FeatCNN-TranCNN, FeatCNN-Tran and ResNet models achieved an accuracy exceeding 99.5 percent . Similarly, for subtle manipulations (for example, 50 percent from A and 50 percent from B and, 75 percent from A and 25 percent from B substitutions) our FeatCNN-TranCNN model demonstrated consistently reliable performance, achieving an average accuracy of 98 percent . For identity verification, the pure Transformer-Siamese network achieved an average accuracy of 98.30 percent . In contrast, the hybrid CNN-Transformer Siamese model delivered perfect verification performance with 100 percent accuracy.

The electrocardiogram (ECG) is an inexpensive and widely available tool for cardiac assessment. Despite its standardized format and small file size, the high complexity and inter-individual variability of ECG signals (typically a 60,000-size vector with 12 leads at 500 Hz) make it challenging to use in deep learning models, especially when only small training datasets are available. This study addresses these challenges by exploring feature generation methods from representative beat ECGs, focusing on Principal Component Analysis (PCA) and Autoencoders to reduce data complexity. We introduce three novel Variational Autoencoder (VAE) variants-Stochastic Autoencoder (SAE), Annealed beta-VAE (A beta-VAE), and Cyclical beta VAE (C beta-VAE)-and compare their effectiveness in maintaining signal fidelity and enhancing downstream prediction tasks using a Light Gradient Boost Machine (LGBM). The A beta-VAE achieved superior signal reconstruction, reducing the mean absolute error (MAE) to 15.7+/-3.2 muV, which is at the level of signal noise. Moreover, the SAE encodings, when combined with traditional ECG summary features, improved the prediction of reduced Left Ventricular Ejection Fraction (LVEF), achieving an holdout test set area under the receiver operating characteristic curve (AUROC) of 0.901 with a LGBM classifier. This performance nearly matches the 0.909 AUROC of state-of-the-art CNN model but requires significantly less computational resources. Further, the ECG feature extraction-LGBM pipeline avoids overfitting and retains predictive performance when trained with less data. Our findings demonstrate that these VAE encodings are not only effective in simplifying ECG data but also provide a practical solution for applying deep learning in contexts with limited-scale labeled training data.