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ECG Semantic Integrator (ESI): A Foundation ECG Model Pretrained with LLM-Enhanced Cardiological Text

The utilization of deep learning on electrocardiogram (ECG) analysis has brought the advanced accuracy and efficiency of cardiac healthcare diagnostics. By leveraging the capabilities of deep learning in semantic understanding, especially in feature extraction and representation learning, this study introduces a new multimodal contrastive pretaining framework that aims to improve the quality and robustness of learned representations of 12-lead ECG signals. Our framework comprises two key components, including Cardio Query Assistant (CQA) and ECG Semantics Integrator(ESI). CQA integrates a retrieval-augmented generation (RAG) pipeline to leverage large language models (LLMs) and external medical knowledge to generate detailed textual descriptions of ECGs. The generated text is enriched with information about demographics and waveform patterns. ESI integrates both contrastive and captioning loss to pretrain ECG encoders for enhanced representations. We validate our approach through various downstream tasks, including arrhythmia detection and ECG-based subject identification. Our experimental results demonstrate substantial improvements over strong baselines in these tasks. These baselines encompass supervised and self-supervised learning methods, as well as prior multimodal pretraining approaches.

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