ECG-Lens: Benchmarking ML & DL Models on PTB-XL Dataset
Authors: Saloni Garg, Ukant Jadia, Amit Sagtani, Kamal Kant Hiran
Abstract
Automated classification of electrocardiogram (ECG) signals is a useful tool for diagnosing and monitoring cardiovascular diseases. This study compares three traditional machine learning algorithms (Decision Tree Classifier, Random Forest Classifier, and Logistic Regression) and three deep learning models (Simple Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM), and Complex CNN (ECGLens)) for the classification of ECG signals from the PTB-XL dataset, which contains 12-lead recordings from normal patients and patients with various cardiac conditions. The DL models were trained on raw ECG signals, allowing them to automatically extract discriminative features. Data augmentation using the Stationary Wavelet Transform (SWT) was applied to enhance model performance, increase the diversity of training samples, and preserve the essential characteristics of the ECG signals. The models were evaluated using multiple metrics, including accuracy, precision, recall, F1-score, and ROC-AUC. The ECG-Lens model achieved the highest performance, with 80% classification accuracy and a 90% ROC-AUC. These findings demonstrate that deep learning architectures, particularly complex CNNs substantially outperform traditional ML methods on raw 12-lead ECG data, and provide a practical benchmark for selecting automated ECG classification models and identifying directions for condition-specific model development.
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.
Deploying deep learning models for automated electrocardiogram classification on resource-constrained wearable devices remains challenging due to high computational costs. To address this, we propose LSTrans, a lightweight hybrid model designed for efficient and sensitive ECG analysis. LSTrans introduces a specialized 1D convolutional backbone with an interleaved layer architecture to capture both macroscopic rhythmic trends and microscopic morphological variations. This backbone is cascaded with a Transformer encoder to model long-range temporal dependencies, incorporating Low-Rank Adaptation across critical layers to compress the model and reduce the trainable parameter space. We further employ homogeneous and heterogeneous knowledge distillation to transfer diagnostic expertise from high-capacity teacher models to the student. Experimental results on multiple benchmark datasets demonstrate that LSTrans achieves a competitive balance between diagnostic sensitivity and resource efficiency, substantially reducing peak memory footprints and training latency during downstream adaptation. The source code is available for review at https://github.com/zyee00128/LSTrans4BIBM.
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.