ECG-RAMBA: Zero-Shot ECG Generalization by Morphology-Rhythm Disentanglement and Long-Range Modeling
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Abstract (arXiv)
Deep learning has achieved strong performance for electrocardiogram (ECG) classification within individual datasets, yet dependable generalization across heterogeneous acquisition settings remains a major obstacle to clinical deployment and longitudinal monitoring. A key limitation of many model architectures is the implicit entanglement of morphological waveform patterns and rhythm dynamics, which can promote shortcut learning and amplify sensitivity to distribution shifts. We propose ECG-RAMBA, a framework that separates morphology and rhythm and then re-integrates them through context-aware fusion. ECG-RAMBA combines: (i) deterministic morphological features extracted by MiniRocket, (ii) global rhythm descriptors computed from heart-rate variability (HRV), and (iii) long-range contextual modeling via a bi-directional Mamba backbone. To improve sensitivity to transient abnormalities under windowed inference, we introduce a numerically stable Power Mean pooling operator (Q=3) that emphasizes high-evidence segments while avoiding the brittleness of max pooling and the dilution of averaging. We evaluate under a protocol-faithful setting with subject-level cross-validation, a fixed decision threshold, and no test-time adaptation. On the Chapman--Shaoxing dataset, ECG-RAMBA achieves a macro ROC-AUC ≈ 0.85. In zero-shot transfer, it attains PR-AUC =0.708 for atrial fibrillation detection on the external CPSC-2021 dataset, substantially outperforming a comparable raw-signal Mamba baseline, and shows consistent cross-dataset performance on PTB-XL. Ablation studies indicate that deterministic morphology provides a strong foundation, while explicit rhythm modeling and long-range context are critical drivers of cross-domain robustness.
Key facts. Cited by 1 paper in the map (data through 7 Oct 2026). Builds on 11 of its 27 references that are in the map. First posted on arXiv 29 Dec 2025.
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11 of 27 references.
References · 11
- 2017Attention Is All You Needcited by 59,932
- 2023Mamba: Linear-Time Sequence Modeling with Selective State Spacescited by 4,616
- 2021Efficiently Modeling Long Sequences with Structured State Spacescited by 2,424
- 2020Shortcut Learning in Deep Neural Networkscited by 1,928
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- 2020MINIROCKET: A Very Fast (Almost) Deterministic Transform for Time Series Classificationcited by 186
- 2019Automatic diagnosis of the 12-lead ECG using a deep neural networkcited by 164
- 2024ECG-FM: An Open Electrocardiogram Foundation Modelcited by 89
- 2024EEG-SSM: Leveraging State-Space Model for Dementia Detectioncited by 11
- 2025TolerantECG: A Foundation Model for Imperfect Electrocardiogramcited by 3
- 2024Empirical investigation of multi-source cross-validation in clinical ECG classificationcited by 2
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Citing papers per year: 2026: 1.
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- 2026Physiology-Aware CNN and Zero-Shot Multimodal LLMs for ECG Image Classification: A Comparative Study
- 2026Pretraining Strategies and Scaling for ECG Foundation Models: A Systematic Study
- 2026HexagonalWarriorMamba: Superior Threshold-Dependent Multi-label Classification of 12-Lead ECG Cardiac Abnormalities
- 2026A Hybrid CNN--State-Space--Attention Backbone with Joint-Embedding Predictive Pretraining for 12-Lead ECG Classification
- 2026ECGQuest: Benchmarking and Fine-Tuning Language Models for Electrocardiography
- 2025Multi-Window Temporal Analysis for Enhanced Arrhythmia Classification: Leveraging Long-Range Dependencies in Electrocardiogram Signals
- 2023Towards quantitative precision for ECG analysis: Leveraging state space models, self-supervision and patient metadata