Zero-Shot Heart Rate Variability Forecasting from Consumer Wearables Using Time Series Foundation Models
Authors: Luukas Peräkylä, Fahad Sohrab, Ville Hautamäki, Merja Heinäniemi, Sui Huang, Pekka Abrahamsson
Organizations: Tampere University, Tampere, Finland · University of Eastern Finland, Finland
Abstract
Short-term Heart Rate Variability (HRV) forecasting could provide clinicians with actionable lead time for detecting autonomic dysfunction and adverse cardiac events. Consumer wearable devices generate fragmented, artifact-rich HRV signals that challenge conventional forecasting approaches. In this study, we evaluated the forecasting ability of three Time Series Foundation Models (TSFMs), TimesFM, Chronos, and MOIRAI, against traditional baselines (Mean, Exponential Smoothing, and Exponentially Weighted Moving Average) on real-world wearable data collected from 49 healthy individuals. To address data fragmentation, we introduce a variability-preserving imputation method that augments linear interpolation with locally adaptive stochastic noise, retaining physiological dynamics essential for accurate forecasting. The results show that TSFMs outperformed all baselines without fine-tuning, achieving average Mean Absolute Scaled Error (MASE) between 0.81 and 0.87 across TSFMs and both context lengths (32 and 64 time steps), with Chronos and TimesFM as the top models, though MOIRAI showed limited gains over baselines. With up to a 2-hour forecast horizon, the results establish a baseline for TSFMs' performance on a real-world dataset, highlighting domain-specific fine-tuning as a promising direction for clinical deployment.
Time-series foundation models have demonstrated strong cross-domain transfer, yet their common architectural assumptions remain poorly aligned with wearable physiological signals, which are multichannel, irregularly sampled, noisy, and governed by coupled continuous-time dynamics spanning distinct spectral scales. We present SOTER, a generative foundation model for wearable physiological time series that unifies cross-channel coupling, spectrum-guided expert specialization, and continuous-time latent evolution within a single pre-training framework. SOTER combines a spatial feature-aware backbone that models inter-signal dependencies, a power spectral density (PSD)-guided mixture-of-experts layer that routes representations to experts associated with fixed spectral bands through an inspectable, non-learned rule, and a neural controlled differential equation decoder that supports prediction and imputation at arbitrary timestamps. We pre-train SOTER on 226 billion time points from five public physiological datasets and evaluate the same pre-trained model across out-of-distribution zero-shot forecasting, frozen-encoder linear-probe classification, and continuous-time imputation on wearable benchmarks. SOTER achieves the best RMSE on 4 of 6 datasets and the best MAE on 5 of 6 in zero-shot forecasting, the highest average Macro-AUROC in classification, and the lowest imputation error on all six datasets at 75% missingness. It further remains robust to additive acquisition noise, matching or surpassing baselines evaluated on clean inputs even under the strongest corruption. These results indicate that domain-specialized foundation models for wearable physiology benefit from jointly modeling channel structure, spectral scale, and continuous-time dynamics.
Inspired by recent breakthroughs in large language models for natural language processing, foundation models have emerged as a promising paradigm for zero-shot time series forecasting, enabling accurate predictions on datasets never seen during pre-training. Ranging from tens to hundreds of millions of parameters, these models are pre-trained on vast and diverse collections of time series, learning generalizable representations that support both point and probabilistic forecasting. This approach alleviates the need for dataset-specific model design and manual tuning, offering a unified solution across forecasting problems. In this work, we review the main architectures, pre-training strategies, and optimization methods underpinning these models. We further investigate post-pre-training fine-tuning of selected foundation models to enhance their performance on specific datasets. Our empirical results demonstrate that this step consistently improves forecasting accuracy over the zero-shot baseline.
Remaining Useful Life (RUL) prediction is essential for industrial predictive maintenance, yet many learning-based approaches rely on extensive feature engineering or large labeled datasets to train task-specific sequence models. In this work, we introduce a lightweight learning approach, in which we leverage a frozen pretrained time-series foundation model (TSFM) and combine it with a small regression head for RUL estimation from multivariate sensor streams. More specifically, we use Chronos-2 as a frozen backbone to extract context window features and train a lightweight regression neural network for RUL prediction. Experiments on real-world industrial sensor data from two device types show that Chronos-2 features consistently improve over recurrent, convolutional, Transformer-based, and gradient-boosting baselines under the same preprocessing and evaluation protocol. We further analyze the impact of context length and find that performance improves significantly with longer histories, indicating that TSFM representation offer a practical and data-efficient alternative for RUL estimation in industrial settings.
Amir El-Ghoussani, Michele De Vita, Ronald Naumann +1