FOCAL is a framework that aligns fine-grained ECG waveform segments with specific report tags using Optimal Transport, addressing the lack of localized representation in prior methods. It introduces a semantic similarity matrix to mitigate false negatives when reports share diagnoses, and a coarse‑to‑fine enrichment pipeline that employs Large Language Models to recover missing waveform semantics while filtering hallucinations. Experiments on six datasets show FOCAL achieves state‑of‑the‑art zero‑shot prediction and linear probing performance.
By Haitao Li, Che Liu, Zhengyao Ding, Ziyi Liu, Wenqi Shao, Zhengxing Huang
arXiv:2608. 09053v1 Announce Type: cross Abstract: Cardiologists interpret electrocardiograms by localizing waveform components, measuring rhythm and interval patterns, and translating these structured observations into diagnostic evidence.
By Hongxiang Gao, He-yang Xu, Yuwen Li, Minghui Zhao, Zhipeng Cai, Xingyao Wang, Chenxi Yang, Jianqing Li, Chengyu Liu
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
Cardiologists interpret electrocardiograms by localizing waveform components, measuring rhythm and interval patterns, and translating these structured observations into diagnostic evidence. Whether this expert reading process can serve as an effective prior for ECG agents remains unclear.
arXiv:2607. 20814v1 Announce Type: new Abstract: The electrocardiogram (ECG) is a cornerstone of cardiac as- sessment, yet clinical deployment of deep learning models remains con- strained by limited interpretability and the hallucination risk of large language models (LLMs).
By Hai-Nam Duy Vuong, Duy-Anh Bui, Trong-Nghia Nguyen, Kim-Ngan Thi Nguyen, Trang Mai Xuan, Tien-Cuong Nguyen, Van-Dem Pham, Thien Van Luong
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
BEAT-Net is a supervised biomimetic framework for ECG diagnosis that incorporates QRS-centered tokenization and a hierarchical architecture mirroring a cardiologist’s workflow. It processes heartbeat sequences through morphological, spatial, temporal, and transformer-based stages, achieving an AUC of 0.924 on large benchmarks while using only 0.7 million parameters. The model outperforms the 39.5‑million‑parameter HeartLang foundation model on morphological form classification and demonstrates superior cross‑dataset generalization with only 35% of the training data.
By Runze Ma, Haonan Lyu, Shunbo Jia, Qiang Yang, Muzi Xu, Jiaqi Zhang, Zihe Luo, Caizhi Liao
arXiv:2603. 08505v2 Announce Type: replace-cross Abstract: Electrocardiography (ECG) is a low-cost, widely used modality for diagnosing electrical abnormalities like atrial fibrillation by capturing the heart's electrical activity.
By Michelle Espranita Liman, \"Ozg\"un Turgut, Alexander M\"uller, Eimo Martens, Daniel Rueckert, Philip M\"uller
ECGQuest is a new benchmark that evaluates language models on the contextual knowledge required for electrocardiogram interpretation, featuring 10,904 True/False questions derived from 23 ECG references and 2003‑2025 Computing in Cardiology proceedings. The study tested 23 commercial and open‑source models, finding that zero‑shot accuracy ranged from 49.5% to 74.4% and that fine‑tuning with Low‑Rank Adaptation improved all open‑source models by 6.5–14.1%, with the best fine‑tuned model achieving 76.3% accuracy and a five‑model ensemble reaching 78.5%. ECGQuest demonstrates that parameter‑efficient fine‑tuning can enable smaller models to compete with larger commercial ones on ECG‑specific tasks.
By Mohammadsina Hassannia, Matthew A. Reyna, Reza Sameni
arXiv:2607. 27404v1 Announce Type: new Abstract: Existing benchmarks for electrocardiogram foundation models primarily evaluate downstream predictive performance, providing limited insight into whether their internal representations can be faithfully decomposed, clinically interpreted, or reproduced across independent analyses.
By Yixuan Duan, Wei Qiu
arXiv:2512. 11095v2 Announce Type: replace Abstract: Label ambiguity is an inherent and largely unaddressed challenge in real-world electrocardiogram (ECG) diagnosis, arising from overlapping conditions and diagnostic disagreements.
By Sana Rahmani, Javad Hashemi, Ali Etemad
arXiv:2606. 00123v1 Announce Type: cross Abstract: Multimodal Large Language Models (MLLMs) have shown strong performance on public medical benchmarks, yet existing evaluations often remain weak proxies for clinical use, relying on isolated inputs and simplified recognition-style tasks.
By Zixian Su, Hongkai Zhang, Fan Gao, Encheng Su, Taiping Qu, Jingwei Guo, Nan Zhang, Hui Wang, Zhen Zhou, Kairui Bo, Yan Chen, Yue Ren, Shuai Li, Lei Xu, Henggui Zhang