On-Device Inference versus Wireless Streaming: Energy-Efficient Multi-Modal Deep Learning for Wearable Cardiovascular Patches

Wearable cardiovascular sensor patches promise continuous, unobtrusive monitoring, but their tight energy, memory, and compute budgets make it unclear whether physiological signals should be analyzed on the device or streamed to the cloud for processing. We study this inference-versus-transmission trade-off for a resource-constrained patch that records synchronized electrocardiogram (ECG) and phonocardiogram (PCG) signals. We propose an end-to-end, multi-modal convolutional neural network (CNN) with early fusion that classifies the two modalities directly on the device, without hand-crafted features. Trained and validated on the PhysioNet/Computing in Cardiology Challenge 2016 dataset, the floating-point model attains an accuracy of 0.975, which is competitive with the best reported results. At the same time, it reduces the parameter count and computational cost by approximately three orders of magnitude. We deploy an 8-bit integer version of the model on a microcontroller with an integrated neural processing unit (NPU) and measure its inference energy. We also benchmark the energy required for Bluetooth Low Energy (BLE) communication on a representative evaluation kit across a range of payload sizes. NPU inference consumes approximately one-seventh of the energy required for CPU inference. For realistic per-second payloads, local inference is also several times more energy efficient than continuous raw-data streaming. These results show that on-device intelligence, rather than constant transmission, is the more energy-efficient basis for always-on wearable cardiovascular monitoring at the edge.