Mingke Yan | Searcharxiv

arXiv2026

ECGJev: Question-Conditioned Option Scoring for 12-Lead ECG Interpretation

Clinical interpretation of a 12-lead electrocardiogram (ECG) often requires answering targeted diagnostic questions with clear, quantifiable decisions. We introduce ECGJev, the first ECG framework built on a decision decoder, a pretrained language model trained to return a probability for every listed option. A question-conditioned bridge compresses frozen waveform and spectrogram features into 16 ECG tokens, and a two-stage procedure adapts the bridge and low-rank adapters on the decoder's native option readout using diagnostic labels alone, scoring all options for a question in one forward pass. Evaluated across four ECG benchmarks, ECGJev achieves the highest macro-F1 on CPSC2018 (80.46%), PTB-XL (71.68%) and Chapman (96.86%), and generalizes competitively to the small-sample PTB cohort. Concept probes and perturbation analyses further show that its predictions rely directly on the ECG input, remain stable under option-order and wording variations, and transfer zero-shot to unseen waveform concepts. Our code is available at https://github.com/zhuoyuanli-lab/ECGJev.

cs.LG↗

arXiv2026

Opportunistic Screening of Wolff-Parkinson-White Syndrome using Single-Lead AI-ECG Mobile System: A Real-World Study of over 3.5 million ECG Recordings in China

Wolff-Parkinson-White (WPW) syndrome, a congenital cardiac conduction abnormality with low prevalence, carries a significant risk of sudden cardiac death. Early identification remains challenging due to screening costs and professional resource scarcity. This retrospective real-world study systematically evaluates an integrated Artificial Intelligence-enabled mobile screening system comprising portable single-lead devices, AI primary screening, and cardiologist review. Analyzing 3,566,626 ECG records from 87,836 individuals between 2019 and 2025, the AI model achieved an AUC of 0.6676 and a specificity of 95.92% in complex real-world signal environments. Despite predictive probability bias inherent in ultra-low prevalence contexts, the model demonstrated stable risk stratification, with high-confidence scores concentrated among true positive individuals. The risk of detecting WPW in AI-positive records was 86.2-fold higher than in AI-negative records. By implementing a human-AI collaborative workflow, the volume of ECGs requiring manual review was reduced by approximately 99.5% compared to universal screening. In an ideal collaborative scenario, an average of only 18 ECGs required review to confirm one WPW case, representing a more than 60-fold increase in screening efficiency. Compared to traditional 12-lead ECGs and electrophysiological studies, this system significantly reduced time and medical costs. Our findings suggest that a risk-stratification-based human-AI collaborative system provides a promising paradigm for the early public health detection of low-prevalence, high-risk arrhythmias.

eess.SP↗