# ExECG: An Explainable AI Framework for ECG models

arXiv: https://arxiv.org/abs/2605.19258 · HTML: https://mlsanity.com/paper/2605.19258/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 38 references that are in the map.
- First posted on arXiv 19 May 2026.

## Builds on (most cited first, 14 of 14)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [A Unified Approach to Interpreting Model Predictions](https://mlsanity.com/paper/1705.07874/) (2017)
- [Axiomatic Attribution for Deep Networks](https://mlsanity.com/paper/1703.01365/) (2017)
- [Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps](https://mlsanity.com/paper/1312.6034/) (2013)
- [Interpretability Beyond Feature Attribution: Quantitative Testing with Concept Activation Vectors (TCAV)](https://mlsanity.com/paper/1711.11279/) (2017)
- [SmoothGrad: removing noise by adding noise](https://mlsanity.com/paper/1706.03825/) (2017)
- [Striving for Simplicity: The All Convolutional Net](https://mlsanity.com/paper/1412.6806/) (2014)
- [Captum: A unified and generic model interpretability library for PyTorch](https://mlsanity.com/paper/2009.07896/) (2020)
- [Automatic diagnosis of the 12-lead ECG using a deep neural network](https://mlsanity.com/paper/1904.01949/) (2019)
- [What Clinicians Want: Contextualizing Explainable Machine Learning for Clinical End Use](https://mlsanity.com/paper/1905.05134/) (2019)
- [Reproducibility in Machine Learning-based Research: Overview, Barriers and Drivers](https://mlsanity.com/paper/2406.14325/) (2024)
- [OmniXAI: A Library for Explainable AI](https://mlsanity.com/paper/2206.01612/) (2022)
- [CoFE: A Framework Generating Counterfactual ECG for Explainable Cardiac AI-Diagnostics](https://mlsanity.com/paper/2508.16033/) (2025)

## Abstract (arXiv)

Deep learning has enabled ECG diagnostic models with strong performance in tasks such as arrhythmia classification and abnormality detection. However, accuracy alone is insufficient for clinical deployment because it does not explain why a specific output was produced, limiting justification, error analysis, and trust. Although ECG XAI has been extensively investigated and steadily improved, practical pipelines and reporting conventions vary across studies, hindering reuse and reproducibility. To address these issues, we present Explainable AI framework for ECG models (ExECG), a Python framework that provides a three-stage pipeline: Wrapper standardizes access across heterogeneous ECG formats and intermediate representations, Explainer unifies diverse XAI methods under a shared execution protocol, and Visualizer supports consistent cross-method comparison within a unified interface. We demonstrate end-to-end usage with concise examples and two case studies, highlighting interoperable and reproducible ECG explainability.