# Multi-modal Heart Failure Risk Estimation based on Short ECG and Sampled Long-Term HRV

arXiv: https://arxiv.org/abs/2403.15408 · HTML: https://mlsanity.com/paper/2403.15408/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 54 references that are in the map.
- First posted on arXiv 1 Mar 2024.

## Builds on (most cited first, 13 of 13)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Learning Phrase Representations using RNN Encoder-Decoder for Statistical Machine Translation](https://mlsanity.com/paper/1406.1078/) (2014)
- [InceptionTime: Finding AlexNet for Time Series Classification](https://mlsanity.com/paper/1909.04939/) (2019)
- [DeepSurv: Personalized Treatment Recommender System Using A Cox Proportional Hazards Deep Neural Network](https://mlsanity.com/paper/1606.00931/) (2016)
- [Time-to-Event Prediction with Neural Networks and Cox Regression](https://mlsanity.com/paper/1907.00825/) (2019)
- [Survival regression with accelerated failure time model in XGBoost](https://mlsanity.com/paper/2006.04920/) (2020)
- [A Survey of Multimodal Information Fusion for Smart Healthcare: Mapping the Journey from Data to Wisdom](https://mlsanity.com/paper/2306.11963/) (2023)
- [XceptionTime: A Novel Deep Architecture based on Depthwise Separable Convolutions for Hand Gesture Classification](https://mlsanity.com/paper/1911.03803/) (2019)
- [Interpretable estimation of the risk of heart failure hospitalization from a 30-second electrocardiogram](https://mlsanity.com/paper/2211.00819/) (2022)

## Built on by (most cited first, 1 of 1)

- [A Laplace diffusion-based transformer model for heart rate forecasting within daily activity context](https://mlsanity.com/paper/2508.16655/) (2025)

## Abstract (arXiv)

Cardiovascular diseases, including Heart Failure (HF), remain a leading global cause of mortality, often evading early detection. In this context, accessible and effective risk assessment is indispensable. Traditional approaches rely on resource-intensive diagnostic tests, typically administered after the onset of symptoms. The widespread availability of electrocardiogram (ECG) technology and the power of Machine Learning are emerging as viable alternatives within smart healthcare. In this paper, we propose several multi-modal approaches that combine 30-second ECG recordings and approximate long-term Heart Rate Variability (HRV) data to estimate the risk of HF hospitalization. We introduce two survival models: an XGBoost model with Accelerated Failure Time (AFT) incorporating comprehensive ECG features and a ResNet model that learns from the raw ECG. We extend these with our novel long-term HRVs extracted from the combination of ultra-short-term beat-to-beat measurements taken over the day. To capture their temporal dynamics, we propose a survival model comprising ResNet and Transformer architectures (TFM-ResNet). Our experiments demonstrate high model performance for HF risk assessment with a concordance index of 0.8537 compared to 14 survival models and competitive discrimination power on various external ECG datasets. After transferability tests with Apple Watch data, our approach implemented in the myHeartScore App offers cost-effective and highly accessible HF risk assessment, contributing to its prevention and management.