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Sep 17

CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representation

Electrocardiography (ECG), photoplethysmography (PPG), and phonocardiography (PCG) provide complementary views of the same cardiac cycle, yet existing cardiac foundation models are trained for a single sensing modality, leaving the shared physiology across sensors unexploited. We introduce CardioState-JEPA, a cardiac foundation model to learn a single shared representation jointly across ECG, PPG, and PCG, built on a physiology-aware joint-embedding predictive architecture. The model maps heterogeneous waveforms into a common token space, processes them with a single shared Transformer encoder, and learns by predicting masked latent cardiac states, placing the pretraining target on shared physiology rather than sensor-specific waveform appearance. To handle the temporal offsets between electrical, mechanical, and hemodynamic events, cross-modal prediction uses a learned delay aligner that matches signals at the corresponding cardiac time. Because synchronized multi-sensor recordings are scarce, CardioState-JEPA first learns within-modality structure from abundant unimodal data and then uses paired data to align modalities in latent cardiac time. Evaluated as a frozen encoder across 25 downstream tasks spanning ECG, PPG, and PCG, our encoder improves average PPG classification by 8.2 AUROC points, PCG murmur detection by 18.8 AUROC points, and ECG classification by 15.5 AUROC points over the best self-supervised signal baseline and matches or exceeds cardiac models trained with privileged clinical text or supervised labels on several ECG benchmarks. These results establish that heterogeneous cardiac signals can mutually supervise a single foundation model of cardiac physiology.

  • 6 authors
·
Aug 12 2

Patient-Aware Contrastive Learning Preserves Per-Patient Structure in RR-Interval Representations

Contrastive representation learning struggles on physiological signals when each subject contributes a distinct baseline pattern. If class differences overlap with subject differences,class-level objectives such as supervised contrastive learning tend to merge per-subject structure into a single per-class cluster,removing the individual variation that a model needs to generalize to unseen patients. We study this problem in the setting of Paroxysmal Atrial Fibrillation(PAF) detection from RR-interval(RRI) sequences and propose a patient-aware contrastive objective that forms positive pairs only from same-patient, same-class segments, preserving each patient's own sinus rhythm(SR) baseline while still pushing the two classes apart. Examining the learned embeddings directly, our objective achieves the most consistent per-patient SR structure (cohesion 0.850 vs. 0.800 for supervised contrastive loss (SupCon) and 0.772 for binary cross-entropy (BCE)). We also identify that BCE produces the cleanest global class separation yet the most disordered per-patient structure. This is precisely why a linear probe trained on its features breaks down on unseen patients. On the IRIDIA-AF dataset, the resulting representation reaches a patient-independent Area Under the Receiver Operating Characteristic Curve (AUROC) of 0.989 pm 0.003 with 2.6times lower seed variance than supervised contrastive baselines.These results highlight that per-subject geometric consistency, rather than global class separability, is key to robust cross-patient generalization.

  • 3 authors
·
Jun 21

QualityFM: a Multimodal Physiological Signal Foundation Model with Self-Distillation for Signal Quality Challenges in Critically Ill Patients

Photoplethysmogram (PPG) and electrocardiogram (ECG) are commonly recorded in intesive care unit (ICU) and operating room (OR). However, the high incidence of poor, incomplete, and inconsistent signal quality, can lead to false alarms or diagnostic inaccuracies. The methods explored so far suffer from limited generalizability, reliance on extensive labeled data, and poor cross-task transferability. To overcome these challenges, we introduce QualityFM, a novel multimodal foundation model for these physiological signals, designed to acquire a general-purpose understanding of signal quality. Our model is pre-trained on an large-scale dataset comprising over 21 million 30-second waveforms and 179,757 hours of data. Our approach involves a dual-track architecture that processes paired physiological signals of differing quality, leveraging a self-distillation strategy where an encoder for high-quality signals is used to guide the training of an encoder for low-quality signals. To efficiently handle long sequential signals and capture essential local quasi-periodic patterns, we integrate a windowed sparse attention mechanism within our Transformer-based model. Furthermore, a composite loss function, which combines direct distillation loss on encoder outputs with indirect reconstruction loss based on power and phase spectra, ensures the preservation of frequency-domain characteristics of the signals. We pre-train three models with varying parameter counts (9.6 M to 319 M) and demonstrate their efficacy and practical value through transfer learning on three distinct clinical tasks: false alarm of ventricular tachycardia detection, the identification of atrial fibrillation and the estimation of arterial blood pressure (ABP) from PPG and ECG signals.

  • 3 authors
·
Sep 8, 2025