# Explainable Deep Learning-based Classification of Wolff-Parkinson-White Electrocardiographic Signals

arXiv: https://arxiv.org/abs/2511.05973 · HTML: https://mlsanity.com/paper/2511.05973/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 68 references that are in the map.
- First posted on arXiv 8 Nov 2025.

## Builds on (most cited first, 11 of 11)

- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Striving for Simplicity: The All Convolutional Net](https://mlsanity.com/paper/1412.6806/) (2014)
- [Network In Network](https://mlsanity.com/paper/1312.4400/) (2013)
- [Deep learning for time series classification: a review](https://mlsanity.com/paper/1809.04356/) (2018)
- [Towards Explainable Artificial Intelligence](https://mlsanity.com/paper/1909.12072/) (2019)
- [Bake off redux: a review and experimental evaluation of recent time series classification algorithms](https://mlsanity.com/paper/2304.13029/) (2023)
- [LightX3ECG: A Lightweight and eXplainable Deep Learning System for 3-lead Electrocardiogram Classification](https://mlsanity.com/paper/2207.12381/) (2022)
- [Improving ECG Classification Interpretability using Saliency Maps](https://mlsanity.com/paper/2201.04070/) (2022)
- [Online structural health monitoring by model order reduction and deep learning algorithms](https://mlsanity.com/paper/2103.14328/) (2021)
- [MedalCare-XL: 16,900 healthy and pathological 12 lead ECGs obtained through electrophysiological simulations](https://mlsanity.com/paper/2211.15997/) (2022)

## Abstract (arXiv)

Wolff-Parkinson-White (WPW) syndrome is a cardiac electrophysiology (EP) disorder caused by the presence of an accessory pathway (AP) that bypasses the atrioventricular node, faster ventricular activation rate, and provides a substrate for atrio-ventricular reentrant tachycardia (AVRT). Accurate localization of the AP is critical for planning and guiding catheter ablation procedures. While traditional diagnostic tree (DT) methods and more recent machine learning (ML) approaches have been proposed to predict AP location from surface electrocardiogram (ECG), they are often constrained by limited anatomical localization resolution, poor interpretability, and the use of small clinical datasets. In this study, we present a Deep Learning (DL) model for the localization of single manifest APs across 24 cardiac regions, trained on a large, physiologically realistic database of synthetic ECGs generated using a personalized virtual heart model. We also integrate eXplainable Artificial Intelligence (XAI) methods, Guided Backpropagation, Grad-CAM, and Guided Grad-CAM, into the pipeline. This enables interpretation of DL decision-making and addresses one of the main barriers to clinical adoption: lack of transparency in ML predictions. Our model achieves localization accuracy above 95%, with a sensitivity of 94.32% and specificity of 99.78%. XAI outputs are physiologically validated against known depolarization patterns, and a novel index is introduced to identify the most informative ECG leads for AP localization. Results highlight lead V2 as the most critical, followed by aVF, V1, and aVL. This work demonstrates the potential of combining cardiac digital twins with explainable DL to enable accurate, transparent, and non-invasive AP localization.