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As the scenarios for electrocardiogram (ECG) monitoring become increasingly diverse, particularly with the development of wearable ECG, the influence of ambiguous factors in diagnosis has been amplified. Reliable ECG information must be extracted from abundant noises and confusing artifacts. To address this issue, we suggest an uncertainty-inspired model for beat-level diagnosis (UI-Beat). The base architecture of UI-Beat separates heartbeat localization and event diagnosis in two branches to address the problem of heterogeneous data sources. To disentangle the epistemic and aleatoric uncertainty within one stage in a deterministic neural network, we propose a new method derived from uncertainty formulation and realize it by introducing the class-biased transformation. Then the disentangled uncertainty can be utilized to screen out noise and identify ambiguous heartbeat synchronously. The results indicate that UI-Beat can significantly improve the performance of noise detection (from 91.60% to 97.50% for real-world noise detection and from 61.40% to 82.41% for real-world artifact detection). For multi-lead ECG analysis, UI-Beat is approaching the performance upper bound in heartbeat localization (only 15 false positives and 9 false negatives out of the 175,907 heartbeats in the INCART database) and achieving a significant performance improvement in heartbeat classification through uncertainty-based cross-lead fusion compared to single-lead prediction and other state-of-the-art methods (an average improvement of 14.28% for detecting heartbeats of S and 3.37% for detecting heartbeats of V). Considering the characteristic of one-stage ECG analysis within one model, it is suggested that the proposed UI-Beat has the potential to be employed as a general model for arbitrary scenarios of ECG monitoring, with the capacity to remove invalid episodes, and realize heartbeat-level diagnosis with confidence provided.

Original publication

DOI

10.1109/JBHI.2025.3545927

Type

Journal article

Journal

IEEE J Biomed Health Inform

Publication Date

26/02/2025

Volume

PP