Diffusion-based Conditional ECG Generation with Structured State Space Models
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Abstract (arXiv)
Synthetic data generation is a promising solution to address privacy issues with the distribution of sensitive health data. Recently, diffusion models have set new standards for generative models for different data modalities. Also very recently, structured state space models emerged as a powerful modeling paradigm to capture long-term dependencies in time series. We put forward SSSD-ECG, as the combination of these two technologies, for the generation of synthetic 12-lead electrocardiograms conditioned on more than 70 ECG statements. Due to a lack of reliable baselines, we also propose conditional variants of two state-of-the-art unconditional generative models. We thoroughly evaluate the quality of the generated samples, by evaluating pretrained classifiers on the generated data and by evaluating the performance of a classifier trained only on synthetic data, where SSSD-ECG clearly outperforms its GAN-based competitors. We demonstrate the soundness of our approach through further experiments, including conditional class interpolation and a clinical Turing test demonstrating the high quality of the SSSD-ECG samples across a wide range of conditions.
Key facts. Cited by 35 papers in the map (data through 7 Oct 2026). Builds on 26 of its 50 references that are in the map. First posted on arXiv 19 Jan 2023.
Builds on
26 of 50 references.
References · 26
- 2020Denoising Diffusion Probabilistic Modelscited by 20,851
- 2021High-Resolution Image Synthesis with Latent Diffusion Modelscited by 18,694
- 2021Diffusion Models Beat GANs on Image Synthesiscited by 8,185
- 2015Deep Unsupervised Learning using Nonequilibrium Thermodynamicscited by 7,005
- 2022Generative Adversarial Networkscited by 5,603
- 2018Large Scale GAN Training for High Fidelity Natural Image Synthesiscited by 2,609
- 2021Efficiently Modeling Long Sequences with Structured State Spacescited by 2,424
- 2022Video Diffusion Modelscited by 2,280
- 2019Generating Long Sequences with Sparse Transformerscited by 1,523
- 2020DiffWave: A Versatile Diffusion Model for Audio Synthesiscited by 1,339
- 2021Cascaded Diffusion Models for High Fidelity Image Generationcited by 1,155
- 2020WaveGrad: Estimating Gradients for Waveform Generationcited by 620
14 more
- 2020HiPPO: Recurrent Memory with Optimal Polynomial Projectionscited by 600
- 2018Bag of Tricks for Image Classification with Convolutional Neural Networkscited by 430
- 2021See through Gradients: Image Batch Recovery via GradInversioncited by 320
- 2022Diffusion-based Time Series Imputation and Forecasting with Structured State Space Modelscited by 195
- 2021How Faithful is your Synthetic Data? Sample-level Metrics for Evaluating and Auditing Generative Modelscited by 193
- 2017Modulating early visual processing by languagecited by 167
- 2020Deep Learning for ECG Analysis: Benchmarks and Insights from PTB-XLcited by 158
- 2022Generating High Fidelity Data from Low-density Regions using Diffusion Modelscited by 78
- 2022TTS-GAN: A Transformer-based Time-Series Generative Adversarial Networkcited by 41
- 2020SimGANs: Simulator-Based Generative Adversarial Networks for ECG Synthesis to Improve Deep ECG Classificationcited by 32
- 2019Synthesis of Realistic ECG using Generative Adversarial Networkscited by 26
- 2022Advancing the State-of-the-Art for ECG Analysis through Structured State Space Modelscited by 9
- 2022Conditional Generative Data Augmentation for Clinical Audio Datasetscited by 5
- 2022Deepfake histological images for enhancing digital pathologycited by 1
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Citing papers per year: 2023: 8; 2024: 14; 2025: 9; 2026: 4.
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- 2024A Survey on Diffusion Models for Time Series and Spatio-Temporal Datacited by 66
- 2024Time Weaver: A Conditional Time Series Generation Modelcited by 35
- 2024Variational Diffusion Posterior Sampling with Midpoint Guidancecited by 32
- 2024Generative AI for Synthetic Data Across Multiple Medical Modalities: A Systematic Review of Recent Developments and Challengescited by 24
- 2023Synthetic ECG Signal Generation using Probabilistic Diffusion Modelscited by 22
- 2025T2S: High-resolution Time Series Generation with Text-to-Series Diffusion Modelscited by 19
- 2023Region-Disentangled Diffusion Model for High-Fidelity PPG-to-ECG Translationcited by 18
- 2023Towards Generative Modeling of Urban Flow through Knowledge-enhanced Denoising Diffusioncited by 17
- 2025DiffuSETS: 12-lead ECG Generation Conditioned on Clinical Text Reports and Patient-Specific Informationcited by 15
- 2024Adaptive Compressed Sensing with Diffusion-Based Posterior Samplingcited by 12
- 2024Generative AI-Driven Human Digital Twin in IoT-Healthcare: A Comprehensive Surveycited by 11
- 2024Transfer Learning for Diffusion Modelscited by 10
23 more
- 2024A Review on Generative AI Models for Synthetic Medical Text, Time Series, and Longitudinal Datacited by 10
- 2023DiffECG: A Versatile Probabilistic Diffusion Model for ECG Signals Synthesiscited by 9
- 2025Simulator and Experience Enhanced Diffusion Model for Comprehensive ECG Generationcited by 8
- 2023A Comprehensive Survey on Generative Diffusion Models for Structured Datacited by 7
- 2023Deep Generative Models for Physiological Signals: A Systematic Literature Reviewcited by 7
- 2024Constrained Posterior Sampling: Time Series Generation with Hard Constraintscited by 6
- 2024A Survey of Transformer Enabled Time Series Synthesiscited by 5
- 2024Explaining Time Series Classification Predictions via Causal Attributionscited by 4
- 2023Bayesian ECG reconstruction using denoising diffusion generative modelscited by 2
- 2025FlowECG: Using Flow Matching to Create a More Efficient ECG Signal Generatorcited by 2
- 2023Prospects for AI-Enhanced ECG as a Unified Screening Tool for Cardiac and Non-Cardiac Conditions -- An Explorative Study in Emergency Carecited by 1
- 2025Conditional Electrocardiogram Generation Using Hierarchical Variational Autoencoderscited by 1
- 2025ECGTwin: Personalized ECG Generation Using Controllable Diffusion Modelcited by 1
- 2026TransConv-DDPM: Enhanced Diffusion Model for Generating Time-Series Data in Healthcarecited by 1
- 2026Drift Estimation for Stochastic Differential Equations with Denoising Diffusion Modelscited by 1
- 2024SSSD-ECG-nle: New Label Embeddings with Structured State-Space Models for ECG generationcited by 0
- 2024ODE-Constrained Generative Modeling of Cardiac Dynamics for 12-Lead ECG Synthesiscited by 0
- 2024Multivariate Data Augmentation for Predictive Maintenance using Diffusioncited by 0
- 2025Challenges and Limitations of Generative AI in Synthesizing Wearable Sensor Datacited by 0
- 2025Diffusion-based translation between unpaired spontaneous premature neonatal EEG and fetal MEGcited by 0
- 2025High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Trainingcited by 0
- 2026VAMP-Diff: VampPrior Latent Diffusion for Photoplethysmography Modelingcited by 0
- 2026Beyond Local Inspection: Global, Guideline-Grounded Evaluation of Post-hoc XAI Methods for ECG Classificationcited by 0
- 2026Beyond Local Inspection: Global, Guideline-Grounded Evaluation of Post-hoc XAI Methods for ECG Classification27 Jul 2026
- 2026VAMP-Diff: VampPrior Latent Diffusion for Photoplethysmography Modeling17 May 2026
- 2026Drift Estimation for Stochastic Differential Equations with Denoising Diffusion Models19 Feb 2026
- 2026TransConv-DDPM: Enhanced Diffusion Model for Generating Time-Series Data in Healthcare3 Feb 2026
- 2025Simulator and Experience Enhanced Diffusion Model for Comprehensive ECG Generation13 Nov 2025
- 2025High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Training7 Oct 2025
- 2025FlowECG: Using Flow Matching to Create a More Efficient ECG Signal Generator31 Aug 2025
- 2025ECGTwin: Personalized ECG Generation Using Controllable Diffusion Model1 Aug 2025
- 2025Diffusion-based translation between unpaired spontaneous premature neonatal EEG and fetal MEG16 Jul 2025
- 2025Challenges and Limitations of Generative AI in Synthesizing Wearable Sensor Data20 May 2025
- 2025T2S: High-resolution Time Series Generation with Text-to-Series Diffusion Models5 May 2025
- 2025Conditional Electrocardiogram Generation Using Hierarchical Variational Autoencoders3 Mar 2025
23 more
- 2025DiffuSETS: 12-lead ECG Generation Conditioned on Clinical Text Reports and Patient-Specific Information10 Jan 2025
- 2024A Review on Generative AI Models for Synthetic Medical Text, Time Series, and Longitudinal Data19 Nov 2024
- 2024Multivariate Data Augmentation for Predictive Maintenance using Diffusion6 Nov 2024
- 2024Constrained Posterior Sampling: Time Series Generation with Hard Constraints16 Oct 2024
- 2024Variational Diffusion Posterior Sampling with Midpoint Guidance13 Oct 2024
- 2024ODE-Constrained Generative Modeling of Cardiac Dynamics for 12-Lead ECG Synthesis26 Sep 2024
- 2024SSSD-ECG-nle: New Label Embeddings with Structured State-Space Models for ECG generation15 Jul 2024
- 2024Adaptive Compressed Sensing with Diffusion-Based Posterior Sampling11 Jul 2024
- 2024Generative AI for Synthetic Data Across Multiple Medical Modalities: A Systematic Review of Recent Developments and Challenges27 Jun 2024
- 2024A Survey of Transformer Enabled Time Series Synthesis4 Jun 2024
- 2024Transfer Learning for Diffusion Models27 May 2024
- 2024Explaining Time Series Classification Predictions via Causal Attributions24 May 2024
- 2024A Survey on Diffusion Models for Time Series and Spatio-Temporal Data29 Apr 2024
- 2024Time Weaver: A Conditional Time Series Generation Model5 Mar 2024
- 2024Generative AI-Driven Human Digital Twin in IoT-Healthcare: A Comprehensive Survey22 Jan 2024
- 2023Bayesian ECG reconstruction using denoising diffusion generative models18 Dec 2023
- 2023Prospects for AI-Enhanced ECG as a Unified Screening Tool for Cardiac and Non-Cardiac Conditions -- An Explorative Study in Emergency Care18 Dec 2023
- 2023Towards Generative Modeling of Urban Flow through Knowledge-enhanced Denoising Diffusion19 Sep 2023
- 2023Region-Disentangled Diffusion Model for High-Fidelity PPG-to-ECG Translation25 Aug 2023
- 2023Deep Generative Models for Physiological Signals: A Systematic Literature Review12 Jul 2023
- 2023A Comprehensive Survey on Generative Diffusion Models for Structured Data7 Jun 2023
- 2023DiffECG: A Versatile Probabilistic Diffusion Model for ECG Signals Synthesis2 Jun 2023
- 2023Synthetic ECG Signal Generation using Probabilistic Diffusion Models4 Mar 2023
- 2024A Survey on Diffusion Models for Time Series and Spatio-Temporal Datacited by 66
- 2024Variational Diffusion Posterior Sampling with Midpoint Guidancecited by 32
- 2023Synthetic ECG Signal Generation using Probabilistic Diffusion Modelscited by 22
- 2025T2S: High-resolution Time Series Generation with Text-to-Series Diffusion Modelscited by 19
- 2023Region-Disentangled Diffusion Model for High-Fidelity PPG-to-ECG Translationcited by 18
- 2023Towards Generative Modeling of Urban Flow through Knowledge-enhanced Denoising Diffusioncited by 17
- 2024Transfer Learning for Diffusion Modelscited by 10
- 2023DiffECG: A Versatile Probabilistic Diffusion Model for ECG Signals Synthesiscited by 9
- 2025Simulator and Experience Enhanced Diffusion Model for Comprehensive ECG Generationcited by 8
- 2023A Comprehensive Survey on Generative Diffusion Models for Structured Datacited by 7
- 2023Bayesian ECG reconstruction using denoising diffusion generative modelscited by 2
- 2026TransConv-DDPM: Enhanced Diffusion Model for Generating Time-Series Data in Healthcarecited by 1
12 most cited of 16 All 16 (JSON)
- 2026VAMP-Diff: VampPrior Latent Diffusion for Photoplethysmography Modeling17 May 2026
- 2026Drift Estimation for Stochastic Differential Equations with Denoising Diffusion Models19 Feb 2026
- 2026TransConv-DDPM: Enhanced Diffusion Model for Generating Time-Series Data in Healthcare3 Feb 2026
- 2025Simulator and Experience Enhanced Diffusion Model for Comprehensive ECG Generation13 Nov 2025
- 2025T2S: High-resolution Time Series Generation with Text-to-Series Diffusion Models5 May 2025
- 2024Multivariate Data Augmentation for Predictive Maintenance using Diffusion6 Nov 2024
- 2024Variational Diffusion Posterior Sampling with Midpoint Guidance13 Oct 2024
- 2024SSSD-ECG-nle: New Label Embeddings with Structured State-Space Models for ECG generation15 Jul 2024
- 2024Transfer Learning for Diffusion Models27 May 2024
- 2024A Survey on Diffusion Models for Time Series and Spatio-Temporal Data29 Apr 2024
- 2023Bayesian ECG reconstruction using denoising diffusion generative models18 Dec 2023
- 2023Towards Generative Modeling of Urban Flow through Knowledge-enhanced Denoising Diffusion19 Sep 2023
12 newest of 16 All 16 (JSON)
- 2024Time Weaver: A Conditional Time Series Generation Modelcited by 35
- 2025DiffuSETS: 12-lead ECG Generation Conditioned on Clinical Text Reports and Patient-Specific Informationcited by 15
- 2024Adaptive Compressed Sensing with Diffusion-Based Posterior Samplingcited by 12
- 2024Generative AI-Driven Human Digital Twin in IoT-Healthcare: A Comprehensive Surveycited by 11
- 2024A Review on Generative AI Models for Synthetic Medical Text, Time Series, and Longitudinal Datacited by 10
- 2023Deep Generative Models for Physiological Signals: A Systematic Literature Reviewcited by 7
- 2024Constrained Posterior Sampling: Time Series Generation with Hard Constraintscited by 6
- 2024A Survey of Transformer Enabled Time Series Synthesiscited by 5
- 2024Explaining Time Series Classification Predictions via Causal Attributionscited by 4
- 2025FlowECG: Using Flow Matching to Create a More Efficient ECG Signal Generatorcited by 2
- 2023Prospects for AI-Enhanced ECG as a Unified Screening Tool for Cardiac and Non-Cardiac Conditions -- An Explorative Study in Emergency Carecited by 1
- 2025Conditional Electrocardiogram Generation Using Hierarchical Variational Autoencoderscited by 1
12 most cited of 18 All 18 (JSON)
- 2026Beyond Local Inspection: Global, Guideline-Grounded Evaluation of Post-hoc XAI Methods for ECG Classification27 Jul 2026
- 2025High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Training7 Oct 2025
- 2025FlowECG: Using Flow Matching to Create a More Efficient ECG Signal Generator31 Aug 2025
- 2025ECGTwin: Personalized ECG Generation Using Controllable Diffusion Model1 Aug 2025
- 2025Diffusion-based translation between unpaired spontaneous premature neonatal EEG and fetal MEG16 Jul 2025
- 2025Challenges and Limitations of Generative AI in Synthesizing Wearable Sensor Data20 May 2025
- 2025Conditional Electrocardiogram Generation Using Hierarchical Variational Autoencoders3 Mar 2025
- 2025DiffuSETS: 12-lead ECG Generation Conditioned on Clinical Text Reports and Patient-Specific Information10 Jan 2025
- 2024A Review on Generative AI Models for Synthetic Medical Text, Time Series, and Longitudinal Data19 Nov 2024
- 2024Constrained Posterior Sampling: Time Series Generation with Hard Constraints16 Oct 2024
- 2024ODE-Constrained Generative Modeling of Cardiac Dynamics for 12-Lead ECG Synthesis26 Sep 2024
- 2024Adaptive Compressed Sensing with Diffusion-Based Posterior Sampling11 Jul 2024
12 newest of 18 All 18 (JSON)
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