ECG-LM: Understanding Electrocardiogram with a Large Language Model

Background: The electrocardiogram (ECG) is a valuable, noninvasive tool for monitoring heart-related conditions, providing critical insights. However, the interpretation of ECG data alongside patient information demands substantial medical expertise and resources. While deep learning methods help st...

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Main Authors: Kai Yang, Massimo Hong, Jiahuan Zhang, Yizhen Luo, Suyuan Zhao, Ou Zhang, Xiaomao Yu, Jiawen Zhou, Liuqing Yang, Ping Zhang, Mu Qiao, Zaiqing Nie
Format: Article
Language:English
Published: American Association for the Advancement of Science (AAAS) 2025-01-01
Series:Health Data Science
Online Access:https://spj.science.org/doi/10.34133/hds.0221
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author Kai Yang
Massimo Hong
Jiahuan Zhang
Yizhen Luo
Suyuan Zhao
Ou Zhang
Xiaomao Yu
Jiawen Zhou
Liuqing Yang
Ping Zhang
Mu Qiao
Zaiqing Nie
author_facet Kai Yang
Massimo Hong
Jiahuan Zhang
Yizhen Luo
Suyuan Zhao
Ou Zhang
Xiaomao Yu
Jiawen Zhou
Liuqing Yang
Ping Zhang
Mu Qiao
Zaiqing Nie
author_sort Kai Yang
collection DOAJ
description Background: The electrocardiogram (ECG) is a valuable, noninvasive tool for monitoring heart-related conditions, providing critical insights. However, the interpretation of ECG data alongside patient information demands substantial medical expertise and resources. While deep learning methods help streamline this process, they often fall short in integrating patient data with ECG readings and do not provide the nuanced clinical suggestions and insights necessary for accurate diagnosis. Methods: Although recent advancements in multi-modal large language modeling have propelled their application scope beyond the natural language processing domain, their applicability to ECG processing remains largely unexplored, partly due to the lack of text–ECG data. To this end, we develop ECG-Language Model (ECG-LM), the first multi-modal large language model able to process natural language and understand ECG signals. The model employs a specialized ECG encoder that transforms raw ECG signals into a high-dimensional feature space, which is then aligned with the textual feature space derived from the large language model. To address the scarcity of text–ECG data, we generated text–ECG pairs by leveraging detailed ECG pattern descriptions from medical guidelines, creating a robust dataset for pre-training ECG-LM. Additionally, we fine-tune ECG-LM with public clinical conversation datasets and build an additional supervised fine-tuning dataset based on real clinical data from the hospital, aiming to provide a more comprehensive and customized user experience. Results: ECG-LM outperforms existing few-shot and zero-shot solutions in cardiovascular disease detection across all 3 tasks (diagnostic, rhythm, and form) while also demonstrating strong potential in ECG-related question answering. Conclusions: The results across various tasks demonstrate that ECG-LM effectively captures the intricate features of ECGs, showcasing its versatility in applications such as disease prediction and advanced question answering.
format Article
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institution Kabale University
issn 2765-8783
language English
publishDate 2025-01-01
publisher American Association for the Advancement of Science (AAAS)
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series Health Data Science
spelling doaj-art-af241abe9a6248fb8b2088869f6837052025-02-04T09:53:00ZengAmerican Association for the Advancement of Science (AAAS)Health Data Science2765-87832025-01-01510.34133/hds.0221ECG-LM: Understanding Electrocardiogram with a Large Language ModelKai Yang0Massimo Hong1Jiahuan Zhang2Yizhen Luo3Suyuan Zhao4Ou Zhang5Xiaomao Yu6Jiawen Zhou7Liuqing Yang8Ping Zhang9Mu Qiao10Zaiqing Nie11Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Beijing Tsinghua Changgung Hospital, Beijing, China.Beijing Tsinghua Changgung Hospital, Beijing, China.Beijing Tsinghua Changgung Hospital, Beijing, China.Beijing Tsinghua Changgung Hospital, Beijing, China.Beijing Tsinghua Changgung Hospital, Beijing, China.PharMolix Inc., Beijing, China.Institute for AI Industry Research (AIR), Tsinghua University, Beijing, China.Background: The electrocardiogram (ECG) is a valuable, noninvasive tool for monitoring heart-related conditions, providing critical insights. However, the interpretation of ECG data alongside patient information demands substantial medical expertise and resources. While deep learning methods help streamline this process, they often fall short in integrating patient data with ECG readings and do not provide the nuanced clinical suggestions and insights necessary for accurate diagnosis. Methods: Although recent advancements in multi-modal large language modeling have propelled their application scope beyond the natural language processing domain, their applicability to ECG processing remains largely unexplored, partly due to the lack of text–ECG data. To this end, we develop ECG-Language Model (ECG-LM), the first multi-modal large language model able to process natural language and understand ECG signals. The model employs a specialized ECG encoder that transforms raw ECG signals into a high-dimensional feature space, which is then aligned with the textual feature space derived from the large language model. To address the scarcity of text–ECG data, we generated text–ECG pairs by leveraging detailed ECG pattern descriptions from medical guidelines, creating a robust dataset for pre-training ECG-LM. Additionally, we fine-tune ECG-LM with public clinical conversation datasets and build an additional supervised fine-tuning dataset based on real clinical data from the hospital, aiming to provide a more comprehensive and customized user experience. Results: ECG-LM outperforms existing few-shot and zero-shot solutions in cardiovascular disease detection across all 3 tasks (diagnostic, rhythm, and form) while also demonstrating strong potential in ECG-related question answering. Conclusions: The results across various tasks demonstrate that ECG-LM effectively captures the intricate features of ECGs, showcasing its versatility in applications such as disease prediction and advanced question answering.https://spj.science.org/doi/10.34133/hds.0221
spellingShingle Kai Yang
Massimo Hong
Jiahuan Zhang
Yizhen Luo
Suyuan Zhao
Ou Zhang
Xiaomao Yu
Jiawen Zhou
Liuqing Yang
Ping Zhang
Mu Qiao
Zaiqing Nie
ECG-LM: Understanding Electrocardiogram with a Large Language Model
Health Data Science
title ECG-LM: Understanding Electrocardiogram with a Large Language Model
title_full ECG-LM: Understanding Electrocardiogram with a Large Language Model
title_fullStr ECG-LM: Understanding Electrocardiogram with a Large Language Model
title_full_unstemmed ECG-LM: Understanding Electrocardiogram with a Large Language Model
title_short ECG-LM: Understanding Electrocardiogram with a Large Language Model
title_sort ecg lm understanding electrocardiogram with a large language model
url https://spj.science.org/doi/10.34133/hds.0221
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