# Domain Knowledge is Power: Leveraging Physiological Priors for Self Supervised Representation Learning in Electrocardiography

arXiv: https://arxiv.org/abs/2509.08116 · HTML: https://mlsanity.com/paper/2509.08116/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 24 of its 56 references that are in the map.
- First posted on arXiv 9 Sep 2025.

## Builds on (most cited first, 24 of 24)

- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [wav2vec 2.0: A Framework for Self-Supervised Learning of Speech Representations](https://mlsanity.com/paper/2006.11477/) (2020)
- [fairseq: A Fast, Extensible Toolkit for Sequence Modeling](https://mlsanity.com/paper/1904.01038/) (2019)
- [What Makes for Good Views for Contrastive Learning?](https://mlsanity.com/paper/2005.10243/) (2020)
- [Masked Autoencoders for Point Cloud Self-supervised Learning](https://mlsanity.com/paper/2203.06604/) (2022)
- [Context Autoencoder for Self-Supervised Representation Learning](https://mlsanity.com/paper/2202.03026/) (2022)
- [Self-Supervised Speech Representation Learning: A Review](https://mlsanity.com/paper/2205.10643/) (2022)
- [CLOCS: Contrastive Learning of Cardiac Signals Across Space, Time, and Patients](https://mlsanity.com/paper/2005.13249/) (2020)
- [Boosting Contrastive Self-Supervised Learning with False Negative Cancellation](https://mlsanity.com/paper/2011.11765/) (2020)
- [ECG-FM: An Open Electrocardiogram Foundation Model](https://mlsanity.com/paper/2408.05178/) (2024)
- [Guiding Masked Representation Learning to Capture Spatio-Temporal Relationship of Electrocardiogram](https://mlsanity.com/paper/2402.09450/) (2024)
- [Self-supervised representation learning from 12-lead ECG data](https://mlsanity.com/paper/2103.12676/) (2021)
- [Contrast Everything: A Hierarchical Contrastive Framework for Medical Time-Series](https://mlsanity.com/paper/2310.14017/) (2023)
- [Lead-agnostic Self-supervised Learning for Local and Global Representations of Electrocardiogram](https://mlsanity.com/paper/2203.06889/) (2022)
- [DinoSR: Self-Distillation and Online Clustering for Self-supervised Speech Representation Learning](https://mlsanity.com/paper/2305.10005/) (2023)
- [3KG: Contrastive Learning of 12-Lead Electrocardiograms using Physiologically-Inspired Augmentations](https://mlsanity.com/paper/2106.04452/) (2021)
- [REBAR: Retrieval-Based Reconstruction for Time-series Contrastive Learning](https://mlsanity.com/paper/2311.00519/) (2023)
- [Multi-Channel Masked Autoencoder and Comprehensive Evaluations for Reconstructing 12-Lead ECG from Arbitrary Single-Lead ECG](https://mlsanity.com/paper/2407.11481/) (2024)
- [Masked Transformer for Electrocardiogram Classification](https://mlsanity.com/paper/2309.07136/) (2023)
- [Which Augmentation Should I Use? An Empirical Investigation of Augmentations for Self-Supervised Phonocardiogram Representation Learning](https://mlsanity.com/paper/2312.00502/) (2023)
- [Self-supervised inter-intra period-aware ECG representation learning for detecting atrial fibrillation](https://mlsanity.com/paper/2410.18094/) (2024)

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

- [Aortic Valve Disease Screening from PPG via Physiology-Guided Self-Supervised Learning](https://mlsanity.com/paper/2602.04266/) (2026)

## Abstract (arXiv)

Objective: Electrocardiograms (ECGs) play a crucial role in diagnosing heart conditions; however, the effectiveness of artificial intelligence (AI)-based ECG analysis is often hindered by the limited availability of labeled data. Self-supervised learning (SSL) can address this by leveraging large-scale unlabeled data. We introduce PhysioCLR (Physiology-aware Contrastive Learning Representation for ECG), a physiology-aware contrastive learning framework that incorporates domain-specific priors to enhance the generalizability and clinical relevance of ECG-based arrhythmia classification. Methods: During pretraining, PhysioCLR learns to bring together embeddings of samples that share similar clinically relevant features while pushing apart those that are dissimilar. Unlike existing methods, our method integrates ECG physiological similarity cues into contrastive learning, promoting the learning of clinically meaningful representations. Additionally, we introduce ECG- specific augmentations that preserve the ECG category post augmentation and propose a hybrid loss function to further refine the quality of learned representations. Results: We evaluate PhysioCLR on two public ECG datasets, Chapman and Georgia, for multilabel ECG diagnoses, as well as a private ICU dataset labeled for binary classification. Across the Chapman, Georgia, and private cohorts, PhysioCLR boosts the mean AUROC by 12% relative to the strongest baseline, underscoring its robust cross-dataset generalization. Conclusion: By embedding physiological knowledge into contrastive learning, PhysioCLR enables the model to learn clinically meaningful and transferable ECG eatures. Significance: PhysioCLR demonstrates the potential of physiology-informed SSL to offer a promising path toward more effective and label-efficient ECG diagnostics.