Lightweight convolutional neural network for binary ECG classification that represents ECG beats as spectrograms (via short-time Fourier transform) rather than raw signals, after denoising and frequency filtration to reduce data volume while preserving diagnostically relevant information. Using the large public PTB-XL dataset, the spectrogram-based CNN reached 99.06% accuracy, outperforming an equivalent raw-signal CNN, while also reducing memory usage and computation by avoiding complex architectures; the authors additionally studied the effect of signal up/down-sampling on classification performance.

CNN-based arrhythmia classifier that fuses the magnitude (scalogram) and phase (phasogram) of the continuous wavelet transform (CWT) of ECG heartbeats, rather than relying on magnitude information alone as most prior 2D-representation approaches do. Several fusion strategies (input-level, intermediate-layer, and output-level fusion) were compared on the public PhysioNet MIT-BIH Arrhythmia database. Despite a simple CNN architecture, the best fusion strategy achieved about 98.5% overall accuracy, 98.5% sensitivity and 95.6% specificity, competitive with more complex state-of-the-art approaches.

Optimized Hierarchical Fused Fuzzy Deep Reinforcement Learning model for predicting non-sinus (higher-risk) cardiac rhythms from PQRST-analyzed 12-lead ECG data. The three-stage approach combines data preprocessing, reinforcement learning, and fuzzy deep learning to classify sinus vs. non-sinus rhythms. Evaluated on a 12-lead ECG dataset of 10,646 patients, OHFFDRL achieved 94% accuracy, an AUC of 0.91, and was interpreted using SHAP, LIME, calibration curves, adversarial vulnerability analysis, and integrated gradients; TAxis (ventricular repolarization movement range) was found to be the most important distinguishing feature.

Self-supervised learning (SSL) model that identifies chronically stressed mother-fetus dyads from raw maternal abdominal ECG (aECG), which contains both maternal and fetal cardiac signals. Built on a self-supervised representation-learning approach originally developed for ECG-based emotion recognition, the model is pretrained on public ECG datasets and evaluated on a cohort of pregnant women with chronic stress exposure validated by psychological inventory, maternal hair cortisol, and the fetal stress index (FSI). Using maternal ECG alone with the publicly pretrained model, it detected the chronic-stress-exposure group with AUROC 0.982 and predicted psychological stress score (R2 0.943), FSI (R2 0.946), and maternal hair cortisol (R2 0.931).

Real-time deep-learning model that fuses serial 12-lead ECG waveforms with sequential vital signs and routinely available clinical data to predict hospital admission early during emergency department (ED) encounters with cardiac presentations (chest pain, dyspnea, syncope, presyncope). Developed and validated on the public MIMIC-IV, MIMIC-IV-ED, and MIMIC-IV-ECG databases (n=30,421 ED stays with >=1 ECG; n=11,273 with >=2 ECGs), the model improves on baseline tabular (random forest) and ECG-only models by leveraging how a patient's risk evolves with successive ECGs during the visit, addressing a key limitation of single-time-point risk scores.

Self-supervised deep learning system that detects ECG anomalies indirectly, by learning to forecast what a normal ECG signal should look like next. FADE is trained only on normal ECG segments using a novel morphology-inspired loss function; at inference time, a large mismatch between the forecast and the observed signal flags an anomaly, avoiding the need for labeled abnormal-beat datasets. Evaluated on the public MIT-BIH NSR and MIT-BIH Arrhythmia databases, FADE reached an average accuracy of 83.84% for anomaly detection and 85.46% for correctly classifying normal ECG, and the approach can be adapted to new recording contexts via domain adaptation.

Explainable machine learning model that detects and localizes left ventricular (LV) scar in hypertrophic cardiomyopathy (HCM) patients directly from 12-lead ECG, as a faster and cheaper alternative to late-gadolinium-enhancement (LGE) cardiac MRI, the clinical gold standard. XplainScar first uses an HCM-specific ECG segmentation algorithm to extract morphological features (duration, amplitude, slope, energy) from the QRS complex, ST segment and T wave of each lead, then combines unsupervised and self-supervised representation learning to predict scar presence and reveal which ECG features are associated with scar location (basal, mid, or apical LV). Trained on 500 HCM patients from the Johns Hopkins HCM Registry and validated on a held-out cohort of 248 HCM patients from UCSF, it reached 88% precision, 90% sensitivity, 78% specificity and an F1-score of 89% for scar detection on the external test set, analyzing a 10-patient batch of ECGs in under one minute.

Multi-label 12-lead ECG diagnosis model submitted to the PhysioNet/Computing in Cardiology Challenge 2020, built on the same residual 1D CNN family as the authors' earlier Nature Communications model but retrained and validated across the challenge's large, multi-institutional pooled training set (CPSC2018, China 12-Lead ECG Database, St. Petersburg INCART, PTB and PTB-XL, and the Georgia 12-Lead ECG Database). The model uses an unsupervised pretraining stage -- predicting unseen samples of a partially masked ECG signal -- before supervised fine-tuning to jointly detect nine diagnostic classes (atrial fibrillation, first-degree AV block, left and right bundle branch block, normal rhythm, premature atrial/ventricular contraction, and ST-segment depression/elevation). The 2020 Challenge was notable for requiring every team to publicly release both their trained model weights and full training code, making this one of relatively few 12-lead ECG classifiers with an end-to-end reproducible public pipeline.

Clinically-informed modification of the ResNet-18 architecture for identifying occlusion myocardial infarction (OMI) -- a severe, often ST-elevation-negative heart attack caused by complete blockage of a coronary artery -- from a single 12-lead ECG. The network first learns lead-specific temporal features via 1xk temporal convolutions, then learns cross-lead spatial concordance/discordance (e.g. reciprocal ST changes) via a 12x1 spatial convolution placed after the residual blocks, with saliency maps highlighting the most relevant leads and waveform regions for explainability. Benchmarked against ResNet-18 and other CNN/random-forest baselines on a multisite real-world clinical dataset of 10,893 ECGs (OMI rate 6.5%), reaching a test AUROC of 0.889 and an average precision of 0.587, outperforming the compared models.

Ensemble classifier combining hand-engineered expert features with a deep convolutional neural network for classifying cardiac rhythm from a single-lead ECG recording into normal sinus rhythm, atrial fibrillation, another rhythm, or too noisy to classify. A large set of expert features (from time-, frequency-, and template-based analysis) is fed into a gradient-boosted tree classifier (AdaBoost), and its output is combined with a separate deep CNN operating directly on the raw waveform; combining both feature families measurably outperformed either alone. ENCASE won 1st place in the PhysioNet/Computing in Cardiology Challenge 2017 (single-lead AF classification) with an overall F1 score of 0.83 on the official hidden test set, and remains a widely cited example of combining classical signal-processing features with deep representations for ECG classification.

Unified deep-learning model for 12-lead ECG analysis that predicts a broad range of cardiac and non-cardiac discharge diagnoses coded under the ICD-10 classification system, evaluated as a unified screening tool for emergency departments where a single ECG could flag many potential conditions at once rather than one disease at a time. Introduces the MIMIC-IV-ECG-ICD-ED benchmark dataset (derived from MIMIC-IV and MIMIC-IV-ECG) and reports AUROC scores across diverse diagnostic scenarios (all discharge diagnoses vs. emergency-department-only diagnoses, cardiac vs. non-cardiac ICD-10 chapters), suggesting integration into emergency-department clinical decision-support systems.

Multi-outcome AI-ECG risk-estimation platform that turns a single 12-lead ECG into a patient-specific survival curve, using a residual convolutional neural network trained with a discrete-time survival loss to predict not just risk but time-to-event. Beyond all-cause and cardiovascular mortality, separately fine-tuned heads predict future ventricular arrhythmia, complete heart block, atrial fibrillation, atherosclerotic cardiovascular disease, heart failure, and (in follow-up work) hypertension -- all from a single resting ECG, including in ECGs a cardiologist would read as normal. Derived on 1.16 million ECGs from 189,539 Beth Israel Deaconess Medical Center patients and externally validated across transnational cohorts in the USA, Brazil (CODE), and the UK (UK Biobank). A variational autoencoder and genome/phenome-wide association analyses were used to show the model's predictions track biologically plausible features (QRS morphology, LV structure/function, and loci linked to cardiac structure, QT interval, and biological aging). NHS trials of AIRE were planned for late 2025. No public code or model weights have been released.

Multimodal machine learning model that flags patients at risk of transthyretin amyloid cardiomyopathy (ATTR-CM) -- a progressive, underdiagnosed disease with expanding disease-modifying treatment options -- from routinely available ECG waveforms, echocardiographic measurements, demographics, and diagnosis codes for orthopedic manifestations of amyloidosis (e.g. carpal tunnel syndrome, spinal stenosis). Developed on 799 patients with 5-fold cross-validation (AUROC 0.85) and externally validated on 422 patients at a separate site (AUROC 0.82), with consistent accuracy across Hispanic, non-Hispanic Black, and non-Hispanic White patients. In a subsequent nonrandomized, single-system, multisite clinical trial (the Cardiac Amyloidosis Discovery Trial), patients flagged by ATTRACTnet and referred for confirmatory amyloid scintigraphy were positive for ATTR-CM 48% of the time, more than 2.8x the positivity rate of historical (15.3%) and contemporary (17.0%) controls referred by usual clinical judgment (P < .001 for both). This is a proprietary clinical AI program; no public code or model weights have been released.

Multimodal deep-learning framework that estimates and forecasts abnormal laboratory values directly from a 12-lead ECG plus routinely available demographics, biometrics, and vital signs -- reframing dozens of blood tests as binary classification targets predictable from a test that is already fast, non-invasive, and nearly universal in acute care. A structured state-space (S4) encoder processes the raw ECG waveform and is late-fused with an MLP encoder over the tabular metadata; the same architecture is trained both to estimate the closest lab value within 60 minutes of the ECG ('abnormality prediction') and to forecast whether a value will become abnormal 30/60/120 minutes into the future ('abnormality forecasting'). Trained and evaluated on 385,480 linked ECG-lab-value samples from 127,994 MIMIC-IV patients, the model reaches AUROC > 0.7 for 24 distinct lab abnormalities in the prediction setting and 24 in the forecasting setting, spanning cardiac, renal, hematological, metabolic, immunological, and coagulation categories -- with NT-proBNP elevation the best-predicted marker (AUROC 0.90), followed by hemoglobin, albumin, and hematocrit derangements (AUROC > 0.82). Code for dataset construction, training, and evaluation is public under an MIT license; no pretrained model weights are released.

Supervised EfficientNetV2-based 12-lead ECG model trained on over 1 million ECGs from the Montreal Heart Institute to predict 77 cardiac conditions derived from American Heart Association recommendations, plus fine-tuned digital-biomarker heads for reduced LVEF, 5-year atrial-fibrillation risk, and long-QT-syndrome (LQTS) detection/genotyping. Validated on 881,403 ECGs across 11 geographically diverse cohorts (4 public, 7 private health systems), achieving AUROCs above 0.98 for the 77-condition interpretation task while being 60x smaller and 29x faster at inference than its self-supervised DeepECG-SSL counterpart, with up to 9.7x lower CO2 emissions on equivalent tasks.

Self-supervised EfficientNetV2-based 12-lead ECG foundation model pretrained via contrastive learning and masked-lead modeling on 1.9 million ECGs (Montreal Heart Institute plus CODE-15% and MIMIC-IV), then fine-tuned for the same 77-condition ECG interpretation task and digital-biomarker extraction as DeepECG-SL. Outperforms the supervised counterpart on label-scarce digital-biomarker tasks, with the largest gains on LQTS genotype classification (AUROC 0.931 vs. 0.850, n=127 ECGs) and 5-year atrial-fibrillation risk (AUROC 0.742 vs. 0.734, n=132,050 ECGs), and outperforms ECG-FM and ECGFounder on shared external diagnostic classes.

Multimodal large language model for ECG medical-report generation and cardiology conversational question-answering. An ECG-CoCa encoder (contrastive ECG-report pretraining in the style of OpenCLIP) is paired with a LLaVA-style vision-language architecture and an LLM backbone, fine-tuned on a purpose-built 45k-example ECG-instruction dataset (19k diagnosis examples + 25k multi-turn dialogue examples) built from five public 12-lead ECG datasets. Produces free-text diagnostic reports and supports zero-shot ECG-report retrieval classification.

Self-supervised ECG representation-learning method that adapts Joint-Embedding Predictive Architecture (JEPA) -- originally developed for images -- to 1D electrocardiogram signals. A Vision Transformer encoder (ViT-XS/S/B) is pretrained to predict masked temporal segments of the ECG directly in latent feature space, using a masking strategy tailored to time-series, on more than 1 million ECGs pooled from MIMIC-IV-ECG, CODE-15%, PTB-XL, Chapman-Shaoxing, CPSC2018/Extra, Georgia, PTB, and St-Petersburg-INCART. After fine-tuning on PTB-XL, the ViT-S/JEPA model reaches 0.945 AUC on the all-statements diagnostic task, exceeding prior self-supervised ECG baselines including CPC and ST-MEM. Developed at the Zuse Institute Berlin.

Explainable Inception-style 1D CNN for multi-label arrhythmia detection from 12-lead ECGs, integrating Grad-CAM visualization to highlight the waveform segments driving each prediction. Trained on MIMIC-IV-ECG and externally validated on PTB-XL across atrial fibrillation, sinus tachycardia, conduction disturbances (RBBB/LBBB/LAFB), long QT, Wolff-Parkinson-White pattern, and paced-rhythm detection, with all metrics exceeding 90% internally and strong generalization on external validation.

First multimodal LLM to unify ECG time series, 12-lead ECG images, and text for grounded, clinician-aligned ECG interpretation. A dual-encoder framework (ECG-CoCa time-series encoder plus a LLaVA-style vision-language backbone) extracts complementary time-series and image features with cross-modal alignment, trained on knowledge-guided instruction data (ECG-Grounding, linking diagnoses to measurable waveform parameters such as QRS/PR intervals) plus the 1.15-million-conversation ECG-Instruct corpus. Introduces the "Grounded ECG Understanding" benchmark and improves predictive performance, explainability, and grounding over prior ECG-language models such as ECG-Chat and PULSE.

Multi-scale ECG-language pretraining model that aligns 12-lead ECG signals with clinical text reports at three granularities -- token, beat, and rhythm level -- rather than a single global embedding. First fine-tunes a cardiology-specialized text encoder to improve understanding of ECG report language, then trains an ECG-FM-initialized ECG encoder against it with hierarchical contrastive supervision. Outperforms prior ECG-language and self-supervised baselines including MERL, ST-MEM, and HeartLang on zero-shot classification, linear probing, and ECG report generation, with especially large gains at low label fractions. Developed at the University of Hong Kong (HKU-MedAI).

Patch-based masked-training framework for robust arrhythmia detection from digitized, multi-layout ECG images (e.g. 3x4, 2x6, 12x1 printed/scanned layouts), designed to handle the asynchronous lead timing and partial signal blackout that digitization introduces. An adaptive variable block-count masking strategy focuses model attention on key patches with cross-lead dependencies. Evaluated on PTB-XL digitized into multiple synthetic layouts and externally validated on 400 real digitized ECG images from Chaoyang Hospital, outperforming classical imputation baselines and the CNN foundation model ECGFounder.

ECG foundation model designed to remain accurate when leads are missing or signals are noisy. A 1D ConvNeXt V2 encoder is trained with a dual-mode self-distillation objective (separate lead-missing and noise "teachers") alongside contrastive alignment to detailed diagnostic-criteria text reports retrieved via a lightweight, LLM-free "Cardiac Feature Retrieval" module. Consistently ranks best or second-best across PTB-XL diagnostic tasks and MIT-BIH arrhythmia classification under original, noisy, lead-missing, and combined-corruption conditions. Developed by FPT Software AI Center and the University of Arkansas.

Foundation model that encodes single-lead (lead I) ECGs with information from paired transthoracic echocardiography reports, aimed at label-efficient screening for structural heart disease (SHD) on wearable and portable single-lead ECG devices. A 7-layer 1D-CNN ECG encoder and a RoBERTa-based text encoder are contrastively pretrained (CLIP-style) on 194,551 ECG-echo report pairs from 77,378 adults in the Yale New Haven Health System, then the ECG encoder is fine-tuned on a temporally-distinct cohort to detect reduced LVEF, diastolic dysfunction, and a composite SHD label. Matches a randomly-initialized CNN at full training-data volume but substantially outperforms it in label-scarce regimes (e.g. with only 0.5% of labeled data).

ECG foundation model built on the xLSTM (extended LSTM) architecture: a bidirectional stack of nine alternating scalar- and matrix-memory LSTM blocks that scales linearly with sequence length, unlike the quadratic cost of transformer-based ECG models. Pretrained with SimDINOv2, a coding-rate-regularized self-distillation (DINO) objective adapted from computer vision to ECG time series, on roughly 8 million recordings from CODE, INCART, and Chapman-Shaoxing-Ningbo. Introduced alongside BenchECG, a standardized 8-dataset/10-task benchmark, on which xECG achieves the best average rank of any publicly available ECG foundation model, with particular strength on long-context tasks (30-minute ambulatory arrhythmia classification, multi-hour sleep-apnea segmentation) where transformer-based models are computationally limited.

Open-source, reproducible pipeline for representing 12-lead ECGs as explicit graphs -- nodes per lead-timepatch, with edges encoding established inter-lead spatial relationships (fully-connected limb- and chest-lead subgraphs bridged via leads I, aVF, V4, and V5) -- and classifying them with a Graph Convolutional Network, paired with GNNExplainer to surface which leads and lead-pairs drove each prediction. Evaluated on PTB-XL for five-class diagnostic superclass classification (AUC 0.86) and, with the same architecture, on anteroseptal-vs-inferior myocardial-infarction localization (AUC 0.92), externally validated on the population-based SHIP cohort (AUC 0.87). Explainability analysis showed the GNN's lead attention recovers standard ECG diagnostic criteria (e.g. V1-V3 for anteroseptal MI, II/III/aVF for inferior MI). Developed at University Medical Center Gottingen; code and an example trained checkpoint are released under CC BY-NC 4.0.

CNN-based image classifier that screens 12-lead ECG images for a signature of transthyretin amyloid cardiomyopathy (ATTR-CM), producing a study-level probability score. Trained on a private Yale New Haven Health System cohort of nuclear-imaging-confirmed ATTR-CM cases and matched controls. Used alongside a companion echocardiography model to track pre-clinical ATTR-CM progression years before it would otherwise be confirmed by nuclear amyloid imaging. Developed by Yale's CarDS Lab and distributed as a packaged research-use executable rather than downloadable weights.

EfficientNet-B3 CNN that detects hypertrophic cardiomyopathy directly from images of printed or scanned 12-lead ECGs, rather than from raw digital waveforms, enabling screening from a photo of a paper tracing. Initialized via self-supervised contrastive pretraining on patient identity, then fine-tuned at Yale New Haven Hospital on over 124,000 ECGs from about 67,000 patients, with HCM status confirmed by cardiac MRI or echocardiography. Externally validated on ECG images from MIMIC-IV, Amsterdam UMC, and UK Biobank. Developed by Yale's CarDS Lab.

Screens 12-lead ECGs for Chagas cardiomyopathy by first pretraining a feature extractor to predict blood-biomarker levels from MIMIC-IV-ECG data, then fine-tuning on Brazilian CODE-15%, SaMi-Trop, and PTB-XL recordings; the final model is a 5-model ensemble. Submitted to the George B. Moody PhysioNet Challenge 2025 (Detection of Chagas Disease from the ECG), where it placed 5th on the official leaderboard. Developed by a team from Akershus University Hospital and the University of Oslo.

1D residual neural network that screens 10-second, 12-lead ECG tracings for six common abnormalities: first- and second-degree AV block patterns, right and left bundle branch block, sinus bradycardia, atrial fibrillation, and sinus tachycardia. Reported F1 scores above 80% and specificity over 99% when benchmarked against cardiology residents. Developed at Universidade Federal de Minas Gerais and trained on the large Brazilian CODE-15% ECG dataset.

Dual-encoder single-lead ECG classifier for atrial fibrillation detection that fuses a raw-signal branch with a spectrogram branch via axial attention and a Transformer. Originally developed as a graduate-course project at TU Darmstadt for the 2017 PhysioNet/CinC Challenge, and later extended in a 2023 follow-up study. Released in four sizes up to 130M parameters (S/M/L/XL), alongside a simpler CNN+LSTM variant.

Open ECG foundation model with 90.9M parameters, built on a wav2vec 2.0-style Transformer and pretrained on 1.25-1.5 million ECGs using a hybrid contrastive-and-generative self-supervised objective. Base pretrained weights and MIMIC-IV-ECG-finetuned downstream checkpoints are both released. Developed on the fairseq_signals framework by the University of Toronto / Vector Institute's Wang lab.

Multi-task 12-lead ECG model with output heads for incident atrial-fibrillation risk (as a survival curve), incident mortality risk, prevalent AF classification, sex classification, and age regression. Built on a 1D CNN over the raw waveform, and developed by the Broad Institute's ML4H group as a successor to their ECG-AI model published in Circulation. Trained on ECGs from UK Biobank and Massachusetts General Hospital, neither of which is publicly released.

Large-scale ECG foundation model pretrained on more than 10 million recordings spanning 150 label categories from the Harvard-Emory ECG Database. Built as a general-purpose feature extractor that can be fine-tuned for arrhythmia detection, demographic inference, and event prediction, and externally validated on MIMIC-IV-ECG and PTB-XL. Also used as the pretrained backbone for downstream clinical models such as Pocket-K, a hyperkalemia detector. Developed by Peking University and Harvard-Emory researchers.

Multimodal ECG model that pairs a 1D ConvNeXtV2 signal encoder with a BioLinkBERT text encoder, trained with a joint contrastive-and-captioning objective using LLM-generated descriptions of ECG demographics and waveform patterns in place of raw clinical reports. Validated on arrhythmia diagnosis and ECG-based subject identification, reaching an AUROC of 0.938 fine-tuned and 0.812 zero-shot on PTB-XL diagnostic classification. Developed at Rice University.

Detects 12 categories of echocardiogram-confirmed structural heart disease from 12-lead ECG waveforms combined with demographic and clinical covariates. Uses the same architecture as the original, larger EchoNext model but is trained entirely on the public EchoNext-Mini dataset - 100,000 de-identified ECGs from Columbia University Irving Medical Center released on PhysioNet - making it one of the more fully reproducible models of its kind, with public weights, a Docker image, and inference code.

Treats ECGs as a language: a QRS-Tokenizer converts raw waveforms into discrete heartbeat 'words' from a learned 8,192-entry vocabulary, and a spatio-temporal transformer (ST-ECGFormer) is pretrained via masked-sentence modeling over these tokens. Evaluated for robust, competitive performance across six public ECG datasets and published at ICLR 2025. Developed by Peking University's digital health group, pretrained on MIMIC-IV-ECG.

Self-supervised foundation model for 12-lead ECGs, pretrained on 9.1 million recordings covering 164 cardiovascular conditions across adult and pediatric cohorts, including single-lead settings. Uses a HuBERT-style Transformer encoder and can be fine-tuned with a simple output layer for diagnosis and event-prediction tasks. Released in small, base, and large (~183M parameter) configurations by researchers at the University of Brescia.

Multimodal model that learns a shared representation space for ECG signals and their clinical text reports, pretrained on paired MIMIC-IV-ECG recordings and reports. Supports zero-shot ECG classification via text prompts, tested across six public benchmark datasets including PTB-XL and CPSC2018 without any downstream training data. Developed at Imperial College London and published at ICML 2024.

CLIP-style model that aligns 12-lead ECG signals with free-text echocardiography reports for zero-shot detection of structural heart disease directly from an ECG. Extends the MERL framework, and was trained on 45,016 paired ECG-echo reports from two Hong Kong hospitals, with external validation on the public EchoNext dataset from Columbia University. Developed by researchers at the University of Hong Kong and Imperial College London; described in a 2025 medRxiv preprint.

Reference benchmark suite for the PTB-XL ECG dataset, providing pretrained xresnet1d, InceptionTime, LSTM, and CPC-pretrained models for 71-label, diagnostic, sub-diagnostic, and super-diagnostic classification of ECG findings. Widely used as a standardized baseline for comparing new ECG classification methods. Developed by Strodthoff et al. at Fraunhofer HHI.