Cardiac arrhythmia, a condition characterized by irregular heartbeats, often serves as an early indication of various heart ailments. With the advent of deep learning, numerous innovative models have been introduced for diagnosing arrhythmias using Electrocardiogram (ECG) signals. However, recent studies solely focus on the performance of models, neglecting the interpretation of their results. This leads to a considerable lack of transparency, posing a significant risk in the actual diagnostic process. To solve this problem, this paper introduces MambaCapsule, a deep neural networks for ECG arrhythmias classification, which increases the explainability of the model while enhancing the accuracy.Our model utilizes Mamba for feature extraction and Capsule networks for prediction, providing not only a confidence score but also signal features. Akin to the processing mechanism of human brain, the model learns signal features and their relationship between them by reconstructing ECG signals in the predicted selection. The model evaluation was conducted on MIT-BIH and PTB dataset, following the AAMI standard. MambaCapsule has achieved a total accuracy of 99.54% and 99.59% on the test sets respectively. These results demonstrate the promising performance of under the standard test protocol.
Deep learning has enabled ECG diagnostic models with strong performance in tasks such as arrhythmia classification and abnormality detection. However, accuracy alone is insufficient for clinical deployment because it does not explain why a specific output was produced, limiting justification, error analysis, and trust. Although ECG XAI has been extensively investigated and steadily improved, practical pipelines and reporting conventions vary across studies, hindering reuse and reproducibility. To address these issues, we present Explainable AI framework for ECG models (ExECG), a Python framework that provides a three-stage pipeline: Wrapper standardizes access across heterogeneous ECG formats and intermediate representations, Explainer unifies diverse XAI methods under a shared execution protocol, and Visualizer supports consistent cross-method comparison within a unified interface. We demonstrate end-to-end usage with concise examples and two case studies, highlighting interoperable and reproducible ECG explainability.
The accurate automated diagnosis of cardiac abnormalities from 12-lead electrocardiograms (ECGs) is critical for managing cardiovascular disease. However, detecting concurrent conditions remains a challenge for traditional deep learning models, which often have limited ability to model the long-range dependencies inherent in ECG signals. This manuscript proposes HexagonalWarriorMamba (HWMamba), a framework built on the Mamba architecture that processes 12-lead ECGs as single-channel 2D images rather than conventional 1D time series. By integrating a hierarchical architecture with a 2D Selective Scan mechanism, HWMamba is designed to model global context and complex spatial relationships within the data. The model is evaluated on the PhysioNet/Computing in Cardiology Challenge 2021 dataset, which includes 26 diagnostic labels and comprises recordings collected from seven institutions across four countries and three continents. Results demonstrate that HWMamba outperforms current state-of-the-art (SOTA) methods across five key threshold-dependent metrics, including Challenge Score and Subset Accuracy. These improvements provide a balance between strong discriminative capability and effective threshold selection derived from the training data, while maintaining near-SOTA performance in Macro AUROC. This Hexagonal Warrior performance, reflecting consistent performance across multiple evaluation dimensions, positions HWMamba as a robust and versatile approach for multi-label ECG classification.
While Deep Learning (DL) enhances automated electrocardiogram (ECG) analysis, clinical deployment is hindered by class imbalance and the generalization gap. This paper presents HeartBeatAI, a deep learning framework combining domain generalization, multi-scale feature aggregation, and clinical explainability for robust 12-lead ECG classification. Moving beyond image-based paradigms, HeartBeatAI integrates a Squeeze-and-Excitation (SE) ResNet to isolate diagnostic leads alongside a Multi-Layer Concentration Pipeline to capture macro-rhythm and micro-morphological anomalies. To mitigate domain shift, the framework employs MixStyle regularization and Label Smoothing. Rigorous benchmarking across four large-scale datasets using intra-source and Leave-One-Domain-Out (LODO) protocols demonstrates high performance (98% Macro F1-score) under intra-source conditions. However, LODO evaluations reveal significant degradation in detecting rare anomalies, highlighting a persistent challenge in cross-institutional deployment.