Deep learning has significantly advanced electrocardiogram (ECG) analysis, enabling automatic annotation, disease screening, and prognosis beyond traditional clinical capabilities. However, understanding these models remains a challenge, limiting interpretation and gaining knowledge from these developments. In this work, we propose a novel interpretability method for convolutional neural networks applied to ECG analysis. Our approach extracts time-localized clusters from the model's internal representations, segmenting the ECG according to the learned characteristics while quantifying the uncertainty of these representations. This allows us to visualize how different waveform regions contribute to the model's predictions and assess the certainty of its decisions. By providing a structured and interpretable view of deep learning models for ECG, our method enhances trust in AI-driven diagnostics and facilitates the discovery of clinically relevant electrophysiological patterns.

Physics - Based Explainable AI for ECG Segmentation: A Lightweight Model Muhammad Fathur Rohman Sidiq Department of Physics, Faculty of Mathematics and Science, Brawijaya University, Malang, Indonesia Abdurrouf Department of Physics, Faculty of Mathematics and Science, Brawijaya University, Malang, Indonesia Didik Rahadi Santoso * Department of Physics, Faculty of Mathematics and Science, Brawijaya University, Malang, Indonesia * Corresponding author. E - mail: dieks@ub.ac.id Abstract The heart's electrical activity, recorded through Electrocardiography (ECG), is essential for diagnosing various cardiovascular conditions. However, many existing ECG segmentation models rely on complex, multi - layered architectures such as BiLSTM, which ar e computationally intensive and inefficient. This study introduces a streamlined architecture that combines spectral analysis with probabilistic predictions for ECG signal segmentation. Additionally, an Explainable AI (XAI) approach is applied to enhance model interpretability by explaining how temporal and frequency - based features contribute to ECG segmentation. By i ncorporating principles from physics - based AI, this method provides a clear understanding of the decision - making process, ensuring reliability and transparency in ECG analysis.

The electrocardiogram (ECG) is an inexpensive and widely available tool for cardiovascular 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) make it challenging to use in deep learning models, especially when only small 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 (Abeta-VAE), and cyclical beta-VAE (Cbeta-VAE), and compare their effectiveness in maintaining signal fidelity and enhancing downstream prediction tasks. The Abeta-VAE achieved superior signal reconstruction, reducing the mean absolute error (MAE) to 15.7 plus-minus 3.2 microvolts, which is at the level of signal noise. Moreover, the SAE encodings, when combined with ECG summary features, improved the prediction of reduced Left Ventricular Ejection Fraction (LVEF), achieving an area under the receiver operating characteristic curve (AUROC) of 0.901. This performance nearly matches the 0.910 AUROC of state-of-the-art CNN models but requires significantly less data and computational resources. 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.

The cardiac dipole has been shown to propagate to the ears, now a common site for consumer wearable electronics, enabling the recording of electrocardiogram (ECG) signals. However, in-ear ECG recordings often suffer from significant noise due to their small amplitude and the presence of other physiological signals, such as electroencephalogram (EEG), which complicates the extraction of cardiovascular features. This study addresses this issue by developing a denoising convolutional autoencoder (DCAE) to enhance ECG information from in-ear recordings, producing cleaner ECG outputs. The model is evaluated using a dataset of in-ear ECGs and corresponding clean Lead I ECGs from 45 healthy participants. The results demonstrate a substantial improvement in signal-to-noise ratio (SNR), with a median increase of 5.9 dB. Additionally, the model significantly improved heart rate estimation accuracy, reducing the mean absolute error by almost 70% and increasing R-peak detection precision to a median value of 90%. We also trained and validated the model using a synthetic dataset, generated from real ECG signals, including abnormal cardiac morphologies, corrupted by pink noise. The results obtained show effective removal of noise sources with clinically plausible waveform reconstruction ability.

In this article, we present a resource-efficient approach for electrocardiogram (ECG) based heartbeat classification using multi-feature fusion and bidirectional long short-term memory (Bi-LSTM). The dataset comprises five original classes from the MIT-BIH Arrhythmia Database: Normal (N), Left Bundle Branch Block (LBBB), Right Bundle Branch Block (RBBB), Premature Ventricular Contraction (PVC), and Paced Beat (PB). Preprocessing methods including the discrete wavelet transform and dual moving average windows are used to reduce noise and artifacts in the raw ECG signal, and extract the main points (PQRST) of the ECG waveform. Multi-feature fusion is achieved by utilizing time intervals and the proposed under-the-curve areas, which are inherently robust against noise, as input features. Simulations demonstrated that incorporating under-the-curve area features improved the classification accuracy for the challenging RBBB and LBBB classes from 31.4% to 84.3% for RBBB, and from 69.6% to 87.0% for LBBB. Using a Bi-LSTM network, rather than a conventional LSTM network, resulted in higher accuracy (33.8% vs 21.8%) with a 28% reduction in required network parameters for the RBBB class. Multiple neural network models with varying parameter sizes, including tiny (84k), small (150k), medium (478k), and large (1.25M) models, are developed to achieve high accuracy across all classes, a more crucial and challenging goal than overall classification accuracy.

Neural network-based models have found wide use in automatic long-term electrocardiogram (ECG) analysis. However, such black box models are inadequate for analysing physiological signals where credibility and interpretability are crucial. Indeed, how to make ECG analysis transparent is still an open problem. In this study, we develop a Tsetlin machine (TM) based architecture for premature ventricular contraction (PVC) identification by analysing long-term ECG signals. The architecture is transparent by describing patterns directly with logical AND rules. To validate the accuracy of our approach, we compare the TM performance with those of convolutional neural networks (CNNs). Our numerical results demonstrate that TM provides comparable performance with CNNs on the MIT-BIH database. To validate interpretability, we provide explanatory diagrams that show how TM makes the PVC identification from confirming and invalidating patterns. We argue that these are compatible with medical knowledge so that they can be readily understood and verified by a medical doctor. Accordingly, we believe this study paves the way for machine learning (ML) for ECG analysis in clinical practice.

The electrical activity in the human heart can be measured as a sequence of amplitudes away from a baseline signal. The segmentation of these regions of ECG waveforms can provide the basis for measurements useful for assessing the overall health of the human heart and the presence of abnormalities [2]. Manually annotating each region of the ECG signal can be a tedious and time-consuming task. Signal processing and deep learning methods potentially can help streamline and automate region-of-interest annotation. This example uses ECG signals from the publicly available QT Database [3] [4].

Physiological signals, such as the electrocardiogram and the phonocardiogram are very often corrupted by noisy sources. Usually, artificial intelligent algorithms analyze the signal regardless of its quality. On the other hand, physicians use a completely orthogonal strategy. They do not assess the entire recording, instead they search for a segment where the fundamental and abnormal waves are easily detected, and only then a prognostic is attempted. Inspired by this fact, a new algorithm that automatically selects an optimal segment for a post-processing stage, according to a criteria defined by the user is proposed. In the process, a Neural Network is used to compute the output state probability distribution for each sample. Using the aforementioned quantities, a graph is designed, whereas state transition constraints are physically imposed into the graph and a set of constraints are used to retrieve a subset of the recording that maximizes the likelihood function, proposed by the user. The developed framework is tested and validated in two applications. In both cases, the system performance is boosted significantly, e.g in heart sound segmentation, sensitivity increases 2.4% when compared to the standard approaches in the literature.

As the advancement of information security, human recognition as its core technology, has absorbed an increasing amount of attention in the past few years. A myriad of biometric features including fingerprint, face, iris, have been applied to security systems, which are occasionally considered vulnerable to forgery and spoofing attacks. Due to the difficulty of being fabricated, electrocardiogram (ECG) has attracted much attention. Though many works have shown the excellent human identification provided by ECG, most current ECG human identification (ECGID) researches only focus on rest situation. In this manuscript, we overcome the oversimplification of previous researches and evaluate the performance under both exercise and rest situations, especially the influence of exercise on ECGID. By applying various existing learning methods to our ECG dataset, we find that current methods which can well support the identification of individuals under rests, do not suffice to present satisfying ECGID performance under exercise situations, therefore exposing the deficiency of existing ECG identification methods.

We present algorithms for the detection of a class of heart arrhythmias with the goal of eventual adoption by practicing cardiologists. In clinical practice, detection is based on a small number of meaningful features extracted from the heartbeat cycle. However, techniques proposed in the literature use high dimensional vectors consisting of morphological, and time based features for detection. Using electrocardiogram (ECG) signals, we found smaller subsets of features sufficient to detect arrhythmias with high accuracy. The features were found by an iterative step-wise feature selection method. We depart from common literature in the following aspects: 1. As opposed to a high dimensional feature vectors, we use a small set of features with meaningful clinical interpretation, 2. we eliminate the necessity of short-duration patient-specific ECG data to append to the global training data for classification 3. We apply semi-parametric classification procedures (in an ensemble framework) for arrhythmia detection, and 4. our approach is based on a reduced sampling rate of ~ 115 Hz as opposed to 360 Hz in standard literature.