DeepBoost-AF: A Novel Unsupervised Feature Learning and Gradient Boosting Fusion for Robust Atrial Fibrillation Detection in Raw ECG Signals

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with elevated health risks, where timely detection is pivotal for mitigating stroke-related morbidity. This study introduces an innovative hybrid methodology integrating unsupervised deep learning and gradient boosting models to improve AF detection. A 19-layer deep convolutional autoencoder (DCAE) is coupled with three boosting classifiers-AdaBoost, XGBoost, and LightGBM (LGBM)-to harness their complementary advantages while addressing individual limitations. The proposed framework uniquely combines DCAE with gradient boosting, enabling end-to-end AF identification devoid of manual feature extraction. The DCAE-LGBM model attains an F1-score of 95.20%, sensitivity of 99.99%, and inference latency of four seconds, outperforming existing methods and aligning with clinical deployment requirements. The DCAE integration significantly enhances boosting models, positioning this hybrid system as a reliable tool for automated AF detection in clinical settings.

Versatile Cardiovascular Signal Generation with a Unified Diffusion Transformer

Cardiovascular signals such as photoplethysmography (PPG), electrocardiography (ECG), and blood pressure (BP) are inherently correlated and complementary, together reflecting the health of cardiovascular system. However, their joint utilization in real-time monitoring is severely limited by diverse acquisition challenges from noisy wearable recordings to burdened invasive procedures. Here we propose UniCardio, a multi-modal diffusion transformer that reconstructs low-quality signals and synthesizes unrecorded signals in a unified generative framework. Its key innovations include a specialized model architecture to manage the signal modalities involved in generation tasks and a continual learning paradigm to incorporate varying modality combinations. By exploiting the complementary nature of cardiovascular signals, UniCardio clearly outperforms recent task-specific baselines in signal denoising, imputation, and translation. The generated signals match the performance of ground-truth signals in detecting abnormal health conditions and estimating vital signs, even in unseen domains, while ensuring interpretability for human experts. These advantages position UniCardio as a promising avenue for advancing AI-assisted healthcare.

Beyond 1D: Vision Transformers and Multichannel Signal Images for PPG-to-ECG Reconstruction

Reconstructing ECG from PPG is a promising yet challenging task. While recent advancements in generative models have significantly improved ECG reconstruction, accurately capturing fine-grained waveform features remains a key challenge. To address this, we propose a novel PPG-to-ECG reconstruction method that leverages a Vision Transformer (ViT) as the core network. Unlike conventional approaches that rely on single-channel PPG, our method employs a four-channel signal image representation, incorporating the original PPG, its first-order difference, second-order difference, and area under the curve. This multi-channel design enriches feature extraction by preserving both temporal and physiological variations within the PPG. By leveraging the self-attention mechanism in ViT, our approach effectively captures both inter-beat and intra-beat dependencies, leading to more robust and accurate ECG reconstruction. Experimental results demonstrate that our method consistently outperforms existing 1D convolution-based approaches, achieving up to 29% reduction in PRD and 15% reduction in RMSE. The proposed approach also produces improvements in other evaluation metrics, highlighting its robustness and effectiveness in reconstructing ECG signals. Furthermore, to ensure a clinically relevant evaluation, we introduce new performance metrics, including QRS area error, PR interval error, RT interval error, and RT amplitude difference error. Our findings suggest that integrating a four-channel signal image representation with the self-attention mechanism of ViT enables more effective extraction of informative PPG features and improved modeling of beat-to-beat variations for PPG-to-ECG mapping. Beyond demonstrating the potential of PPG as a viable alternative for heart activity monitoring, our approach opens new avenues for cyclic signal analysis and prediction.

Recognition of Physiological Patterns during Activities of Daily Living Using Wearable Biosignal Sensors

A key aspect of developing fall prevention systems is the early prediction of a fall before it occurs. This paper presents a statistical overview of results obtained by analyzing 22 activities of daily living to recognize physiological patterns and estimate the risk of an imminent fall. The results demonstrate distinctive patterns between high-intensity and low-intensity activity using EMG, ECG, and respiration sensors, also indicating the presence of a proportional trend between movement velocity and muscle activity. These outcomes highlight the potential benefits of using these sensors in the future to direct the development of an activity recognition and risk prediction framework for physiological phenomena that can cause fall injuries.

Identifying Heart Attack Risk in Vulnerable Population: A Machine Learning Approach

The COVID-19 pandemic has significantly increased the incidence of post-infection cardiovascular events, particularly myocardial infarction, in individuals over 40. While the underlying mechanisms remain elusive, this study employs a hybrid machine learning approach to analyze epidemiological data in assessing 13 key heart attack risk factors and their susceptibility. Based on a unique dataset that combines demographic, biochemical, ECG, and thallium stress-tests, this study categorizes distinct subpopulations against varying risk profiles and then divides the population into 'at-risk' (AR) and 'not-at-risk' (NAR) groups using clustering algorithms. The study reveals strong association between the likelihood of experiencing a heart attack on the 13 risk factors studied. The aggravated risk for postmenopausal patients indicates compromised individual risk factors due to estrogen depletion that may be, further compromised by extraneous stress impacts, like anxiety and fear, aspects that have traditionally eluded data modeling predictions.

CardioPatternFormer: Pattern-Guided Attention for Interpretable ECG Classification with Transformer Architecture

Accurate ECG interpretation is vital, yet complex cardiac data and "black-box" AI models limit clinical utility. Inspired by Transformer architectures' success in NLP for understanding sequential data, we frame ECG as the heart's unique "language" of temporal patterns. We present CardioPatternFormer, a novel Transformer-based model for interpretable ECG classification. It employs a sophisticated attention mechanism to precisely identify and classify diverse cardiac patterns, excelling at discerning subtle anomalies and distinguishing multiple co-occurring conditions. This pattern-guided attention provides clear insights by highlighting influential signal regions, effectively allowing the "heart to talk" through transparent interpretations. CardioPatternFormer demonstrates robust performance on challenging ECGs, including complex multi-pathology cases. Its interpretability via attention maps enables clinicians to understand the model's rationale, fostering trust and aiding informed diagnostic decisions. This work offers a powerful, transparent solution for advanced ECG analysis, paving the way for more reliable and clinically actionable AI in cardiology.

Signal, Image, or Symbolic: Exploring the Best Input Representation for Electrocardiogram-Language Models Through a Unified Framework

Recent advances have increasingly applied large language models (LLMs) to electrocardiogram (ECG) interpretation, giving rise to Electrocardiogram-Language Models (ELMs). Conditioned on an ECG and a textual query, an ELM autoregressively generates a free-form textual response. Unlike traditional classification-based systems, ELMs emulate expert cardiac electrophysiologists by issuing diagnoses, analyzing waveform morphology, identifying contributing factors, and proposing patient-specific action plans. To realize this potential, researchers are curating instruction-tuning datasets that pair ECGs with textual dialogues and are training ELMs on these resources. Yet before scaling ELMs further, there is a fundamental question yet to be explored: What is the most effective ECG input representation? In recent works, three candidate representations have emerged-raw time-series signals, rendered images, and discretized symbolic sequences. We present the first comprehensive benchmark of these modalities across 6 public datasets and 5 evaluation metrics. We find symbolic representations achieve the greatest number of statistically significant wins over both signal and image inputs. We further ablate the LLM backbone, ECG duration, and token budget, and we evaluate robustness to signal perturbations. We hope that our findings offer clear guidance for selecting input representations when developing the next generation of ELMs.

Fine-Grained ECG-Text Contrastive Learning via Waveform Understanding Enhancement

Electrocardiograms (ECGs) are essential for diagnosing cardiovascular diseases. While previous ECG-text contrastive learning methods have shown promising results, they often overlook the incompleteness of the reports. Given an ECG, the report is generated by first identifying key waveform features and then inferring the final diagnosis through these features. Despite their importance, these waveform features are often not recorded in the report as intermediate results. Aligning ECGs with such incomplete reports impedes the model's ability to capture the ECG's waveform features and limits its understanding of diagnostic reasoning based on those features. To address this, we propose FG-CLEP (Fine-Grained Contrastive Language ECG Pre-training), which aims to recover these waveform features from incomplete reports with the help of large language models (LLMs), under the challenges of hallucinations and the non-bijective relationship between waveform features and diagnoses. Additionally, considering the frequent false negatives due to the prevalence of common diagnoses in ECGs, we introduce a semantic similarity matrix to guide contrastive learning. Furthermore, we adopt a sigmoid-based loss function to accommodate the multi-label nature of ECG-related tasks. Experiments on six datasets demonstrate that FG-CLEP outperforms state-of-the-art methods in both zero-shot prediction and linear probing across these datasets.

Heart2Mind: Human-Centered Contestable Psychiatric Disorder Diagnosis System using Wearable ECG Monitors

Psychiatric disorders affect millions globally, yet their diagnosis faces significant challenges in clinical practice due to subjective assessments and accessibility concerns, leading to potential delays in treatment. To help address this issue, we present Heart2Mind, a human-centered contestable psychiatric disorder diagnosis system using wearable electrocardiogram (ECG) monitors. Our approach leverages cardiac biomarkers, particularly heart rate variability (HRV) and R-R intervals (RRI) time series, as objective indicators of autonomic dysfunction in psychiatric conditions. The system comprises three key components: (1) a Cardiac Monitoring Interface (CMI) for real-time data acquisition from Polar H9/H10 devices; (2) a Multi-Scale Temporal-Frequency Transformer (MSTFT) that processes RRI time series through integrated time-frequency domain analysis; (3) a Contestable Diagnosis Interface (CDI) combining Self-Adversarial Explanations (SAEs) with contestable Large Language Models (LLMs). Our MSTFT achieves 91.7% accuracy on the HRV-ACC dataset using leave-one-out cross-validation, outperforming state-of-the-art methods. SAEs successfully detect inconsistencies in model predictions by comparing attention-based and gradient-based explanations, while LLMs enable clinicians to validate correct predictions and contest erroneous ones. This work demonstrates the feasibility of combining wearable technology with Explainable Artificial Intelligence (XAI) and contestable LLMs to create a transparent, contestable system for psychiatric diagnosis that maintains clinical oversight while leveraging advanced AI capabilities. Our implementation is publicly available at: https://github.com/Analytics-Everywhere-Lab/heart2mind.

Trial and Trust: Addressing Byzantine Attacks with Comprehensive Defense Strategy

Recent advancements in machine learning have improved performance while also increasing computational demands. While federated and distributed setups address these issues, their structure is vulnerable to malicious influences. In this paper, we address a specific threat, Byzantine attacks, where compromised clients inject adversarial updates to derail global convergence. We combine the trust scores concept with trial function methodology to dynamically filter outliers. Our methods address the critical limitations of previous approaches, allowing functionality even when Byzantine nodes are in the majority. Moreover, our algorithms adapt to widely used scaled methods like Adam and RMSProp, as well as practical scenarios, including local training and partial participation. We validate the robustness of our methods by conducting extensive experiments on both synthetic and real ECG data collected from medical institutions. Furthermore, we provide a broad theoretical analysis of our algorithms and their extensions to aforementioned practical setups. The convergence guarantees of our methods are comparable to those of classical algorithms developed without Byzantine interference.