Organizations: China Mobile Research Institute, Beijing, China · China Mobile GBA (Greater Bay Area) Innovation Institute, Guangzhou, China · Beijing Jiaotong University, Beijing, China · Institute of Microelectronics, Chinese Academy of Sciences, Beijing, China · Purple Mountain Laboratory, Nanjing, China
Abstract
In light of strides in Arti cial Intelligence (AI) and its wide spread application, challenges persist in the interpretability of AI models, particularly within specialized domains like healthcare, such as electro cardiograph (ECG) recognition. Rather than relying solely on end-to-end convolutional neural networks, this paper introduces a novel approach using a domain knowledge-based graph convolution network for ECG recognition. Key landmarks points of PRQST, vital to ECG interpreta tion, are incorporated as domain knowledge. The double-stream directed graph is employed to model both intra and inter ECG cycles. Speci cally, spatial directed graphs capture the positional relationships among key points, while temporal directed graphs delineate temporal dependencies between adjacent cycles in extended ECG sequences. Experimental re sults on the First Chinese ECG Intelligent Competition dataset, which speci cally classify ECG into nine categories, prove the e cacy of the proposed model. The overall average F1 score is 88.1%, the average F1 score of rare categories is 76.3%, both outperform the state-of-the-art models. The introduction of domain knowledge did enhance the detec tion performance, especially for rare categories.
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.
High-fidelity ECG interpretation is increasingly reliant on massive foundation models, yet their deployment in clinical edge-care remains hindered by extreme computational demands. While knowledge distillation (KD) is a promising solution, traditional methods fail to capture the complex spatio-temporal dependencies of ECG signals when transferring knowledge across heterogeneous architectures. In this paper, we propose EVL-ECG, a framework specifically designed for cross-architecture distillation of cardiac diagnostic logic. EVL-ECG introduces three ECG-aware innovations: (1) Multi-Head Cross-Attention Alignment, which harmonizes architectural discrepancies to preserve fine-grained morphological features; (2) Optimal Transport-based Visual Feature Matching, utilizing optimal transport to maintain global structural relationships across ECG leads despite mismatched token representations; and (3) Geometric Intra-Architecture Relation Matching, which distills the latent diagnostic reasoning of the teacher model. Evaluations across ECG benchmarks demonstrate that EVL-ECG yields improvements of up to 2.4% AUC and 1.1% clinical accuracy over existing baselines. Notably, EVL-ECG establishes an efficient 2B-parameter ECG foundation model, suitable for resource-constrained clinical environments.
Electrocardiogram (ECG)-based biometric recognition has emerged as a promising solution for secure authentication and liveness detection. However, most existing methods rely on unimodal deep learning architectures that independently process either one-dimensional (1D) temporal signals or two-dimensional (2D) time-frequency representations, limiting robustness and generalization. To address this issue, this paper proposes a hybrid framework integrating 1D and 2D convolutional neural networks (CNNs) within a unified end-to-end architecture. The 1D branch extracts temporal and morphological features from raw ECG signals, while the 2D branch captures discriminative spectral information from time-frequency representations. An attention-guided fusion mechanism dynamically weights both modalities according to input characteristics, overcoming the limitations of conventional static fusion strategies. The framework was evaluated on three benchmark datasets (ECG-ID, MIT-BIH, and PTB), including healthy subjects and patients with cardiac pathologies, achieving identification accuracies of 99.56%, 100.00%, and 99.89%, respectively. To assess long-term biometric permanence, experiments were also conducted on the multi-session Heartprint dataset spanning ten years. The proposed approach achieved same-session accuracies of 98.54% (S1), 99.09% (S2), 94.93% (S3R), and 96.08% (S3L), while cross-session evaluations reached 56.33% (S1-S2) and 53.27% (S2-S3R), demonstrating the ability to capture stable biometric signatures over time. The optimal configuration combines InceptionTime for 1D processing, ResNet-34 for 2D analysis, and attention-based fusion. Ablation studies confirm that the proposed attention mechanism consistently outperforms conventional fusion approaches. Overall, the proposed framework provides a robust, scalable, and high-performance solution for ECG biometric recognition.