Frozen Language Model Helps ECG Zero-Shot Learning

The electrocardiogram (ECG) is one of the most commonly used non-invasive, convenient medical monitoring tools that assist in the clinical diagnosis of heart diseases. Recently, deep learning (DL) techniques, particularly self-supervised learning (SSL), have demonstrated great potential in the classification of ECG. SSL pre-training has achieved competitive performance with only a small amount of annotated data after fine-tuning. However, current SSL methods rely on the availability of annotated data and are unable to predict labels not existing in fine-tuning datasets. To address this challenge, we propose Multimodal ECG-Text Self-supervised pre-training (METS), the first work to utilize the auto-generated clinical reports to guide ECG SSL pre-training. We use a trainable ECG encoder and a frozen language model to embed paired ECG and automatically machine-generated clinical reports separately. The SSL aims to maximize the similarity between paired ECG and auto-generated report while minimize the similarity between ECG and other reports. In downstream classification tasks, METS achieves around 10% improvement in performance without using any annotated data via zero-shot classification, compared to other supervised and SSL baselines that rely on annotated data. Furthermore, METS achieves the highest recall and F1 scores on the MIT-BIH dataset, despite MIT-BIH containing different classes of ECG compared to the pre-trained dataset. The extensive experiments have demonstrated the advantages of using ECG-Text multimodal self-supervised learning in terms of generalizability, effectiveness, and efficiency.