arXiv AI

Fine-tuning an ECG Foundation Model to Predict Coronary CT Angiography Outcomes

A multicenter study developed an AI-enabled electrocardiography (AI-ECG) model that predicts vessel-specific hemodynamically significant stenosis using coronary computed tomographic angiography (CCTA) as the reference. The model demonstrated strong discrimination in internal and external cohorts, including normal ECGs, and produced low-, intermediate-, and high-risk strata that correlated with stenosis severity and major adverse cardiovascular events. Calibration, decision curve analyses, and integration with guideline-based pre-test probability showed clinical utility, while waveform and attribution analyses revealed physiologically meaningful ECG features linked to high-risk predictions.

arXiv Machine Learning
Jul 21

ECG-LLM: Foundation Model for ECG-Based Cardiac Reasoning

arXiv:2607. 16323v1 Announce Type: cross Abstract: Electrocardiography (ECG) is an inexpensive, standard-of-care test for cardiac symptoms, but front-line triage often lacks immediate access to definitive imaging such as echocardiography (ECHO) or cardiac magnetic resonance (CMR).

By Alexander Selivanov, Friederike Jungmann, Jan Kehrer, Karl-Ludwig Laugwitz, Eimo Martens, Daniel Rueckert
arXiv AI
Sep 10

Leveraging Cardiac Imaging to Improve ECG-Based Detection of Chagas Disease in Resource-Constrained Settings

The study demonstrates that contrastive pre‑training of ECG representations using cardiac magnetic resonance (CMR) imaging data can enhance ECG‑based detection of Chagas disease. By aligning an ECG encoder with a CMR embedding space from 63,193 paired UK Biobank examinations, the authors achieved higher AUROC and sensitivity metrics on CODE‑15%, SaMi‑Trop, and PhysioNet/CinC 2025 Challenge datasets compared to an unaligned baseline. The approach shows that imaging‑supervised ECG representations generalize across different populations and resource‑constrained settings.

By Laura Alvarez-Florez, Daniel Uyterlinde, Samuel Ruip\'erez-Campillo, Lukas P. A. Arts, Folkert W. Asselbergs, Fleur V. Y. Tjong
arXiv Machine Learning
Sep 7

Learning from VAE Errors to support ECG-based Differential Diagnosis of Myocardial Scar

The study investigates whether ECG representations derived from a β-variational autoencoder (VAE) can distinguish patients with myocardial scar (LGE+) from those without (LGE-) using routine ECG data. In a cohort of 300 cardiomyopathic patients, the β-VAE achieved an AUC of 0.577 (sensitivity 0.775) with Gradient Boosting, while the foundation ECGx.AI model reached an AUC of 0.686 with Random Forest. Dynamic Time Warping reconstruction errors differed significantly between classes in most leads and improved classification to an AUC of 0.643 with Logistic Regression, suggesting these errors could serve as markers of scar-related ECG changes.

By Shayan Sharifi, Riccardo Treu, Ilaria Gandin, Federico Garoia, Marco Merlo, Giulia Cisotto
arXiv Machine Learning
Jul 28

Beyond Local Inspection: Global, Guideline-Grounded Evaluation of Post-hoc XAI Methods for ECG Classification

arXiv:2607. 24035v1 Announce Type: cross Abstract: Explainable AI (XAI) is used to assess whether artificial intelligence models rely on meaningful patterns, yet explanations that appear plausible for individual predictions may systematically misrepresent model behavior.

By Nils Gumpfer, Michael Guckert, Samuel Sossalla, Birgit A{\ss}mus, Jennifer Hannig
arXiv AI
Sep 30

Multi-Site Real-World Performance of Commercial AI for Pulmonary and Incidental Pulmonary Embolism Detection

arXiv:2609.37750v1 Announce Type: cross Abstract: Pulmonary embolism (PE) is a leading cause of cardiovascular mortality, yet the real-world performance of FDA-cleared AI detection models remains inc...

By Aawez Mansuri, Mohammadreza Chavoshi, Theodorus Dapamede, Wasif Bala, Beatrice Brown-Mulry, Rohan Isaac, Bardia Khosravi, Hanzhou Li, Frank Li, John T. Moon, Chad Robichaux, Dan I. G. Cohen-Addad, Ninad V. Salastekar, Janice Newsome, Judy W. Gichoya, Hari Trivedi