构建统一基准,评估心电图模型对房颤的检测能力
FOUND-AF: Benchmarking ECG Foundation Models for Atrial Fibrillation Detection

- 用相同数据与流程测试9个心电图模型,确保公平比较
- ECGFounder模型在多个数据集上表现最佳,兼顾准确率与效率
- 适合临床部署,为心电图模型选型提供可靠参考
房颤是最常见的持续性心律失常,与中风、心力衰竭和死亡风险升高相关。近期的心电图基础模型可提供可迁移的表征用于自动房颤检测。然而,由于使用不同数据集、预处理方式、分类器和验证协议,现有研究的相对有效性仍不明确。本研究提出FOUND-AF,一个统一、防泄露、面向部署的基准框架,可在相同实验条件下评估预训练心电图表征的质量。在四个异构心电图数据集(AFDB、CinC2017、CPSC2021、LTAFDB)上,评估了来自五个家族的九个公开基础模型:HuBERT-ECG、CLEF、ST-MEM、ECG-JEPA 和 ECGFounder。所有模型均作为冻结特征提取器,采用标准化预处理、模型原生重采样、固定XGBoost分类器及记录级分组交叉验证。评估涵盖分类指标、受试者工作特征分析、带霍尔姆校正的配对记录级自举比较、嵌入空间可视化和计算效率分析。ECGFounder模型在各数据集上均表现出最强综合性能,并在准确率、模型大小、推理时间和内存占用之间取得良好平衡。FOUND-AF因此提供了一个可复现的框架,用于选择心电图基础模型,并证明紧凑的临床预训练编码器可在异构采集环境下支持鲁棒且高效的房颤检测。
原文摘要 · Abstract (English)
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with increased risks of stroke, heart failure, and mortality. Recent ECG foundation models offer transferable representations for automated AF detection. However, their relative effectiveness remains unclear because existing studies use different datasets, preprocessing procedures, classifiers, and validation protocols. This study presents FOUND-AF, a unified, leakage-controlled, and deployment-oriented benchmarking framework that evaluates the quality of pretrained ECG representations under identical experimental conditions. Nine publicly available foundation models from five families, including HuBERT-ECG, CLEF, ST-MEM, ECG-JEPA, and ECGFounder, were evaluated across four heterogeneous ECG datasets, namely AFDB, CinC2017, CPSC2021, and LTAFDB. All models were used as frozen feature extractors with standardized preprocessing, model-native resampling, a fixed XGBoost classifier, and recording-level grouped cross-validation. The evaluation included classification metrics, receiver operating characteristic analysis, paired recording-level bootstrap comparisons with Holm correction, embedding-space visualization, and computational efficiency profiling. The ECGFounder model consistently achieved the strongest overall performance across datasets while offering a favorable trade-off between accuracy, model size, inference time, and memory usage. FOUND-AF therefore provides a reproducible framework for selecting ECG foundation models and demonstrates that compact, clinically pretrained encoders can support robust and computationally efficient AF detection across heterogeneous acquisition settings.
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