HRVConformer: Neonatal Hypoxic-Ischemic Encephalopathy Classification from the Heart Rate signals
Authors: Shuwen Yu, William P Marnane, Geraldine B. Boylan, Gordon Lightbody
Organizations: Department of Electrical & Electronic Engineering, School of Engineering and Architecture, University College Cork, Cork, Ireland · INFANT Research Centre, University College Cork, Cork, Ireland · Pediatrics and Child Health, University College Cork, Cork, Ireland
Abstract
This paper presents the HRVConformer, a novel deep learning architecture for the classification of hypoxic-ischemic encephalopathy (HIE) using the instantaneous heart rate (HR) signal. Unlike conventional approaches that rely on handcrafted features, HRVConformer directly processes raw HR signals in an end-to-end manner, capturing both local and long-range dependencies through a hybrid Convolution-Transformer framework. By integrating convolutional layers for local feature extraction and Transformer-based attention mechanisms for global context modelling, the architecture effectively enhances signal representation and classification performance. The model was trained using supervised learning on a large HR dataset consisting of 1,573 one-hour epochs, including 259 one-hour expert-annotated epochs and a substantial set of weakly labelled data. A 314-hour validation set provided a robust performance estimation, while an independent 215-hour dataset with expert annotations was reserved for final testing. HR signals were extracted from electrocardiogram (ECG) recordings using an improved Pan-Tompkins algorithm, which significantly enhanced both signal quality and data availability. Experimental results demonstrate that the HRVConformer achieves an AUC of 83.23% and accuracy of 74.56% on the test set. These results surpass the performance of the Transformer, ResNet50 and fully convolutional networks baselines, highlighting the advantages of integrating convolutional and Transformer-based components for HR-based HIE classification. The proposed method provides a promising step toward a more accurate and automated assessment of HIE using HR signals. The code is available at: https://github.com/syu-kylin/HRVConformer.
In this paper, we propose the MAEConformer, a novel self-supervised learning framework that combines the Conformer architecture with the Masked Autoencoder (MAE) paradigm for large-scale representation learning from unlabelled electroencephalography (EEG) and heart rate variability (HRV) signals. By integrating convolutional operations with Transformer-based self-attention, MAEConformer effectively captures both local temporal patterns and long-range contextual dependencies in physiological time series. To enhance reconstruction fidelity and representation quality, a multi-resolution short-time Fourier transform (MR-STFT) loss is incorporated alongside the reconstruction objective, enabling the model to jointly learn temporal and spectral characteristics across multiple scales. Modality-specific EEG and HRV MAEConformer models were pretrained on 6,030h and 4,868h of unlabelled recordings, respectively, and subsequently transferred to expert-annotated downstream tasks. Experimental results demonstrate that the learned representations provide strong transferability and data efficiency. In EEG-based hypoxic ischemic encephalopathy (HIE) severity classification, the pretrained MAE-EEG model achieved test AUCs of 97.19% and 96.56% for binary and four-class classification tasks, respectively, outperforming a range of state-of-the-art supervised and self-supervised baselines. On the HRV-based HIE severity classification task, MAE-HRV achieved a test AUC of 82.42%, surpassing both self-supervised Transformer-based and supervised convolutional baselines. These findings demonstrate the effectiveness of MAEConformer for learning robust and transferable representations across multiple physiological modalities.
Shuwen Yu, William P Marnane, Geraldine B. Boylan +1
The monitoring of fetal heart rate (FHR) and the assessment of its variability are crucial for preventing fetal compromise and adverse outcomes. However, traditional methods encounter limitations arising from equipment performance, data transmission, and subjective assessments by doctors. We have developed a tailored AI-based FHrCTG model specifically for FHR monitoring, which effectively mitigates noise interference and precisely reconstructs signals. Our model was pre-trained on a massive dataset consisting of 558,412 unlabeled data points and further refined using 7,266 expert-reviewed entries. To validate FHR, we introduced the Intersection Overlapping Labels (IOL) approach, which transforms rate analysis into categorical judgments. Testing revealed that our model demonstrates high sensitivity and specificity in detecting critical FHR decelerations (89.13% and 87.78%, respectively) and accelerations (62.5% and 92.04%, respectively). Furthermore, based on Fischer's criteria for clinical application, our model achieved impressive AUC scores of 0.7214 and 0.9643 for verifying FHR periodicity and amplitude variation, respectively.
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.