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Explainable Parallel CNN-LSTM Model for Differentiating Ventricular Tachycardia from Supraventricular Tachycardia with Aberrancy in 12-Lead ECGs

Background and Objective: Differentiating wide complex tachycardia (WCT) is clinically critical yet challenging due to morphological similarities in electrocardiogram (ECG) signals between life-threatening ventricular tachycardia (VT) and supraventricular tachycardia with aberrancy (SVT-A). Misdiagnosis carries fatal risks. We propose a computationally efficient deep learning solution to improve diagnostic accuracy and provide model interpretability for clinical deployment. Methods: A novel lightweight parallel deep architecture is introduced. Each pipeline processes individual ECG leads using two 1D-CNN blocks to extract local features. Feature maps are concatenated across leads, followed by LSTM layers to capture temporal dependencies. Final classification employs fully connected layers. Explainability is achieved via Shapley Additive Explanations (SHAP) for local/global interpretation. The model was evaluated on a 35-subject ECG database using standard performance metrics. Results: The model achieved $95.63\%$ accuracy ($95\%$ CI: $93.07-98.19\%$), with sensitivity=$95.10\%$, specificity=$96.06\%$, and F1-score=$95.12\%$. It outperformed state-of-the-art methods in both accuracy and computational efficiency, requiring minimal CNN blocks per pipeline. SHAP analysis demonstrated clinically interpretable feature contributions. Conclusions: Our end-to-end framework delivers high-precision WCT classification with minimal computational overhead. The integration of SHAP enhances clinical trust by elucidating decision logic, supporting rapid, informed diagnosis. This approach shows significant promise for real-world ECG analysis tools.

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