ECG-Chat: A Large ECG-Language Model for Cardiac Disease Diagnosis
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Abstract (arXiv)
The success of Multimodal Large Language Models (MLLMs) in the medical auxiliary field shows great potential, allowing patients to engage in conversations using physiological signal data. However, general MLLMs perform poorly in cardiac disease diagnosis, particularly in the integration of ECG data analysis and medical report generation, mainly due to the complexity of ECG data analysis and the gap between text and ECG signal modalities. To address these issues, we propose ECG-Chat, a multitask MLLMs focused on ECG medical report generation, providing multimodal conversational capabilities based on cardiology knowledge. We propose a contrastive learning approach that integrates ECG waveform data with text reports, aligning ECG features with reports in a fine-grained manner. This method also results in an ECG encoder that excels in zero-shot report retrieval tasks. Additionally, expanding existing datasets, we constructed a 19k ECG diagnosis dataset and a 25k multi-turn dialogue dataset for training and fine-tuning ECG-Chat, which provides professional diagnostic and conversational capabilities. Furthermore, ECG-Chat can generate comprehensive ECG analysis reports through an automated LaTeX generation pipeline. We established a benchmark for the ECG report generation task and tested our model on multiple baselines. ECG-Chat achieved the best performance in classification, retrieval, and medical report generation tasks. Our code is available at https://github.com/YubaoZhao/ECG-Chat.
Key facts. Cited by 37 papers in the map (data through 7 Oct 2026). First posted on arXiv 16 Aug 2024.
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Citing papers per year: 2024: 1; 2025: 16; 2026: 20.
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- 2025SensorLM: Learning the Language of Wearable Sensorscited by 44
- 2025GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Imagescited by 35
- 2025How Can Time Series Analysis Benefit From Multiple Modalities? A Survey and Outlookcited by 20
- 2025From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretrainingcited by 15
- 2025PhysioWave: A Multi-Scale Wavelet-Transformer for Physiological Signal Representationcited by 12
- 2025OpenECG: Benchmarking ECG Foundation Models with Public 1.2 Million Recordscited by 10
- 2024ECG-Byte: A Tokenizer for End-to-End Generative Electrocardiogram Language Modelingcited by 9
- 2026ECG-R1: Protocol-Guided and Modality-Agnostic MLLM for Reliable ECG Interpretationcited by 8
- 2025MedTVT-R1: A Multimodal LLM Empowering Medical Reasoning and Diagnosiscited by 7
- 2025ShizhenGPT: Towards Multimodal LLMs for Traditional Chinese Medicinecited by 6
- 2025ECG-Expert-QA: A Benchmark for Evaluating Medical Large Language Models in Heart Disease Diagnosiscited by 5
- 2025Knowledge-enhanced Multimodal ECG Representation Learning with Arbitrary-Lead Inputscited by 5
25 more
- 2025DentalGPT: Incentivizing Multimodal Complex Reasoning in Dentistrycited by 5
- 2025UniECG: Understanding and Generating ECG in One Unified Modelcited by 4
- 2026ECG-Agent: On-Device Tool-Calling Agent for ECG Multi-Turn Dialoguecited by 4
- 2025Signal, Image, or Symbolic: Exploring the Best Input Representation for Electrocardiogram-Language Models Through a Unified Frameworkcited by 2
- 2025Retrieval-Augmented Generation for Electrocardiogram-Language Modelscited by 2
- 2026ECG-Reasoning-Benchmark: A Benchmark for Evaluating Clinical Reasoning Capabilities in ECG Interpretationcited by 2
- 2026UniPACT: A Multimodal Framework for Prognostic Question Answering on Raw ECG and Structured EHRcited by 1
- 2026Time Series, Vision, and Language: Exploring the Limits of Alignment in Contrastive Representation Spacescited by 1
- 2026DeepArrhythmia: Segment-Contextualized ECG Arrhythmia Classification via Selective Evidence Acquisitioncited by 1
- 2025From Time Series Analysis to Question Answering: A Survey in the LLM Eracited by 0
- 2025ECG-LLM -- training and evaluation of domain-specific large language models for electrocardiographycited by 0
- 2026ELF: A Family of Encoder-Free ECG-Language Modelscited by 0
- 2026CAMEL: An ECG Language Model for Forecasting Cardiac Eventscited by 0
- 2026VLM-in-the-Loop: A Plug-In Quality Assurance Module for ECG Digitization Pipelinescited by 0
- 2026Reasoning Before Diagnosis: Physician-Inspired Structured Thinking for ECG Classificationcited by 0
- 2026Information-theoretic Multimodal Representation Learning for Electrocardiogram Signalscited by 0
- 2026EVL-ECG: Efficient ECG Interpretation With Multi-Aspect Heterogeneous Knowledge Distillationcited by 0
- 2026Enhancing Explainable Cardiac Diagnosis with Guide-Grounded Multimodal LLMscited by 0
- 2026Cardiologent: Multi-Agent Clinical Decision Support for Patient-Level Arrhythmia Assessment, Urgency, and Managementcited by 0
- 2026ECG-LENS: Lead-Aware Clinical Context Enriched ECG Report Generation and Evaluationcited by 0
- 2026Diagnosing as Cardiologists Do: ECG Agents with Doctor-Grounded Priors for Clinical Reasoning Across Diseases and Populationscited by 0
- 2026Decoder Design Matters for ECG Delineationcited by 0
- 2026PhysioBench: A Unified Benchmark for Physiological Signal Question Answeringcited by 0
- 2026Large language models in medical time series analysiscited by 0
- 2026TRACE: Expert-Aligned ECG Representation Learning with Rigorous Benchmarking and Real-World Validation in Acute Cardiac Carecited by 0
- 2026TRACE: Expert-Aligned ECG Representation Learning with Rigorous Benchmarking and Real-World Validation in Acute Cardiac Care28 Sep 2026
- 2026Decoder Design Matters for ECG Delineation15 Sep 2026
- 2026Large language models in medical time series analysis7 Sep 2026
- 2026Diagnosing as Cardiologists Do: ECG Agents with Doctor-Grounded Priors for Clinical Reasoning Across Diseases and Populations10 Aug 2026
- 2026ECG-LENS: Lead-Aware Clinical Context Enriched ECG Report Generation and Evaluation6 Aug 2026
- 2026PhysioBench: A Unified Benchmark for Physiological Signal Question Answering29 Jul 2026
- 2026Cardiologent: Multi-Agent Clinical Decision Support for Patient-Level Arrhythmia Assessment, Urgency, and Management28 Jul 2026
- 2026Enhancing Explainable Cardiac Diagnosis with Guide-Grounded Multimodal LLMs23 Jul 2026
- 2026EVL-ECG: Efficient ECG Interpretation With Multi-Aspect Heterogeneous Knowledge Distillation28 May 2026
- 2026Information-theoretic Multimodal Representation Learning for Electrocardiogram Signals26 May 2026
- 2026Reasoning Before Diagnosis: Physician-Inspired Structured Thinking for ECG Classification17 May 2026
- 2026DeepArrhythmia: Segment-Contextualized ECG Arrhythmia Classification via Selective Evidence Acquisition15 May 2026
25 more
- 2026VLM-in-the-Loop: A Plug-In Quality Assurance Module for ECG Digitization Pipelines1 Apr 2026
- 2026ECG-Reasoning-Benchmark: A Benchmark for Evaluating Clinical Reasoning Capabilities in ECG Interpretation15 Mar 2026
- 2026Time Series, Vision, and Language: Exploring the Limits of Alignment in Contrastive Representation Spaces22 Feb 2026
- 2026CAMEL: An ECG Language Model for Forecasting Cardiac Events17 Feb 2026
- 2026ECG-R1: Protocol-Guided and Modality-Agnostic MLLM for Reliable ECG Interpretation4 Feb 2026
- 2026ECG-Agent: On-Device Tool-Calling Agent for ECG Multi-Turn Dialogue28 Jan 2026
- 2026UniPACT: A Multimodal Framework for Prognostic Question Answering on Raw ECG and Structured EHR25 Jan 2026
- 2026ELF: A Family of Encoder-Free ECG-Language Models5 Jan 2026
- 2025DentalGPT: Incentivizing Multimodal Complex Reasoning in Dentistry12 Dec 2025
- 2025ECG-LLM -- training and evaluation of domain-specific large language models for electrocardiography21 Oct 2025
- 2025Retrieval-Augmented Generation for Electrocardiogram-Language Models30 Sep 2025
- 2025UniECG: Understanding and Generating ECG in One Unified Model23 Sep 2025
- 2025ShizhenGPT: Towards Multimodal LLMs for Traditional Chinese Medicine20 Aug 2025
- 2025MedTVT-R1: A Multimodal LLM Empowering Medical Reasoning and Diagnosis23 Jun 2025
- 2025From Time Series Analysis to Question Answering: A Survey in the LLM Era13 Jun 2025
- 2025PhysioWave: A Multi-Scale Wavelet-Transformer for Physiological Signal Representation12 Jun 2025
- 2025From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretraining11 Jun 2025
- 2025SensorLM: Learning the Language of Wearable Sensors10 Jun 2025
- 2025Signal, Image, or Symbolic: Exploring the Best Input Representation for Electrocardiogram-Language Models Through a Unified Framework24 May 2025
- 2025How Can Time Series Analysis Benefit From Multiple Modalities? A Survey and Outlook14 Mar 2025
- 2025GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Images8 Mar 2025
- 2025OpenECG: Benchmarking ECG Foundation Models with Public 1.2 Million Records2 Mar 2025
- 2025Knowledge-enhanced Multimodal ECG Representation Learning with Arbitrary-Lead Inputs25 Feb 2025
- 2025ECG-Expert-QA: A Benchmark for Evaluating Medical Large Language Models in Heart Disease Diagnosis16 Feb 2025
- 2024ECG-Byte: A Tokenizer for End-to-End Generative Electrocardiogram Language Modeling18 Dec 2024
- 2025MedTVT-R1: A Multimodal LLM Empowering Medical Reasoning and Diagnosiscited by 7
- 2025DentalGPT: Incentivizing Multimodal Complex Reasoning in Dentistrycited by 5
- 2026ECG-Reasoning-Benchmark: A Benchmark for Evaluating Clinical Reasoning Capabilities in ECG Interpretationcited by 2
- 2026Reasoning Before Diagnosis: Physician-Inspired Structured Thinking for ECG Classificationcited by 0
- 2026Reasoning Before Diagnosis: Physician-Inspired Structured Thinking for ECG Classification17 May 2026
- 2026ECG-Reasoning-Benchmark: A Benchmark for Evaluating Clinical Reasoning Capabilities in ECG Interpretation15 Mar 2026
- 2025DentalGPT: Incentivizing Multimodal Complex Reasoning in Dentistry12 Dec 2025
- 2025MedTVT-R1: A Multimodal LLM Empowering Medical Reasoning and Diagnosis23 Jun 2025
- 2025SensorLM: Learning the Language of Wearable Sensorscited by 44
- 2025GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Imagescited by 35
- 2025How Can Time Series Analysis Benefit From Multiple Modalities? A Survey and Outlookcited by 20
- 2025From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretrainingcited by 15
- 2025PhysioWave: A Multi-Scale Wavelet-Transformer for Physiological Signal Representationcited by 12
- 2025OpenECG: Benchmarking ECG Foundation Models with Public 1.2 Million Recordscited by 10
- 2024ECG-Byte: A Tokenizer for End-to-End Generative Electrocardiogram Language Modelingcited by 9
- 2026ECG-R1: Protocol-Guided and Modality-Agnostic MLLM for Reliable ECG Interpretationcited by 8
- 2025ECG-Expert-QA: A Benchmark for Evaluating Medical Large Language Models in Heart Disease Diagnosiscited by 5
- 2025Knowledge-enhanced Multimodal ECG Representation Learning with Arbitrary-Lead Inputscited by 5
- 2025UniECG: Understanding and Generating ECG in One Unified Modelcited by 4
- 2026ECG-Agent: On-Device Tool-Calling Agent for ECG Multi-Turn Dialoguecited by 4
12 most cited of 30 All 30 (JSON)
- 2026TRACE: Expert-Aligned ECG Representation Learning with Rigorous Benchmarking and Real-World Validation in Acute Cardiac Care28 Sep 2026
- 2026Decoder Design Matters for ECG Delineation15 Sep 2026
- 2026Large language models in medical time series analysis7 Sep 2026
- 2026Diagnosing as Cardiologists Do: ECG Agents with Doctor-Grounded Priors for Clinical Reasoning Across Diseases and Populations10 Aug 2026
- 2026ECG-LENS: Lead-Aware Clinical Context Enriched ECG Report Generation and Evaluation6 Aug 2026
- 2026PhysioBench: A Unified Benchmark for Physiological Signal Question Answering29 Jul 2026
- 2026Cardiologent: Multi-Agent Clinical Decision Support for Patient-Level Arrhythmia Assessment, Urgency, and Management28 Jul 2026
- 2026Enhancing Explainable Cardiac Diagnosis with Guide-Grounded Multimodal LLMs23 Jul 2026
- 2026EVL-ECG: Efficient ECG Interpretation With Multi-Aspect Heterogeneous Knowledge Distillation28 May 2026
- 2026Information-theoretic Multimodal Representation Learning for Electrocardiogram Signals26 May 2026
- 2026DeepArrhythmia: Segment-Contextualized ECG Arrhythmia Classification via Selective Evidence Acquisition15 May 2026
- 2026VLM-in-the-Loop: A Plug-In Quality Assurance Module for ECG Digitization Pipelines1 Apr 2026
12 newest of 30 All 30 (JSON)