# CAMEL: An ECG Language Model for Forecasting Cardiac Events

arXiv: https://arxiv.org/abs/2602.15677 · HTML: https://mlsanity.com/paper/2602.15677/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 11 of its 40 references that are in the map.
- First posted on arXiv 17 Feb 2026.

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

- [ECG-FM: An Open Electrocardiogram Foundation Model](https://mlsanity.com/paper/2408.05178/) (2024)
- [Zero-Shot ECG Classification with Multimodal Learning and Test-time Clinical Knowledge Enhancement](https://mlsanity.com/paper/2403.06659/) (2024)
- [Frozen Language Model Helps ECG Zero-Shot Learning](https://mlsanity.com/paper/2303.12311/) (2023)
- [ECG-QA: A Comprehensive Question Answering Dataset Combined With Electrocardiogram](https://mlsanity.com/paper/2306.15681/) (2023)
- [ECG-Chat: A Large ECG-Language Model for Cardiac Disease Diagnosis](https://mlsanity.com/paper/2408.08849/) (2024)
- [MEIT: Multimodal Electrocardiogram Instruction Tuning on Large Language Models for Report Generation](https://mlsanity.com/paper/2403.04945/) (2024)
- [Teach Multimodal LLMs to Comprehend Electrocardiographic Images](https://mlsanity.com/paper/2410.19008/) (2024)
- [From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretraining](https://mlsanity.com/paper/2506.21803/) (2025)
- [anyECG-chat: A Generalist ECG-MLLM for Flexible ECG Input and Multi-Task Understanding](https://mlsanity.com/paper/2506.00942/) (2025)
- [ECG-Byte: A Tokenizer for End-to-End Generative Electrocardiogram Language Modeling](https://mlsanity.com/paper/2412.14373/) (2024)
- [Electrocardiogram Report Generation and Question Answering via Retrieval-Augmented Self-Supervised Modeling](https://mlsanity.com/paper/2409.08788/) (2024)

## Abstract (arXiv)

Electrocardiograms (ECG) are electrical recordings of the heart that are critical for diagnosing cardiovascular conditions. ECG language models (ELMs) have recently emerged as a promising framework for ECG classification accompanied by report generation. However, current models cannot forecast future cardiac events despite the immense clinical value for planning earlier intervention. To address this gap, we propose CAMEL, the first ELM that is capable of inference over longer signal durations which enables its forecasting capability. Our key insight is a specialized ECG encoder which enables cross-understanding of ECG signals with text. We train CAMEL using established LLM training procedures, combining LoRA adaptation with a curriculum learning pipeline. Our curriculum includes ECG classification, metrics calculations, and multi-turn conversations to elicit reasoning. CAMEL demonstrates strong zero-shot performance across 6 tasks and 9 datasets, including ECGForecastBench, a new benchmark that we introduce for forecasting arrhythmias. CAMEL is on par with or surpasses ELMs and fully supervised baselines both in- and out-of-distribution, achieving SOTA results on ECGBench (+7.0% absolute average gain) as well as ECGForecastBench (+12.4% over fully supervised models and +21.1% over zero-shot ELMs).