A Systematic Review of ECG Arrhythmia Classification: Adherence to Standards, Fair Evaluation, and Embedded Feasibility

The classification of electrocardiogram (ECG) signals is crucial for early detection of arrhythmias and other cardiac conditions. However, despite advances in machine learning, many studies fail to follow standardization protocols, leading to inconsistencies in performance evaluation and real-world applicability. Additionally, hardware constraints essential for practical deployment, such as in pacemakers, Holter monitors, and wearable ECG patches, are often overlooked. Since real-world impact depends on feasibility in resource-constrained devices, ensuring efficient deployment is critical for continuous monitoring. This review systematically analyzes ECG classification studies published between 2017 and 2024, focusing on those adhering to the E3C (Embedded, Clinical, and Comparative Criteria), which include inter-patient paradigm implementation, compliance with Association for the Advancement of Medical Instrumentation (AAMI) recommendations, and model feasibility for embedded systems. While many studies report high accuracy, few properly consider patient-independent partitioning and hardware limitations. We identify state-of-the-art methods meeting E3C criteria and conduct a comparative analysis of accuracy, inference time, energy consumption, and memory usage. Finally, we propose standardized reporting practices to ensure fair comparisons and practical applicability of ECG classification models. By addressing these gaps, this study aims to guide future research toward more robust and clinically viable ECG classification systems.

A Decidability-Based Loss Function

Nowadays, deep learning is the standard approach for a wide range of problems, including biometrics, such as face recognition and speech recognition, etc. Biometric problems often use deep learning models to extract features from images, also known as embeddings. Moreover, the loss function used during training strongly influences the quality of the generated embeddings. In this work, a loss function based on the decidability index is proposed to improve the quality of embeddings for the verification routine. Our proposal, the D-loss, avoids some Triplet-based loss disadvantages such as the use of hard samples and tricky parameter tuning, which can lead to slow convergence. The proposed approach is compared against the Softmax (cross-entropy), Triplets Soft-Hard, and the Multi Similarity losses in four different benchmarks: MNIST, Fashion-MNIST, CIFAR10 and CASIA-IrisV4. The achieved results show the efficacy of the proposal when compared to other popular metrics in the literature. The D-loss computation, besides being simple, non-parametric and easy to implement, favors both the inter-class and intra-class scenarios.