# Information-theoretic Multimodal Representation Learning for Electrocardiogram Signals

arXiv: https://arxiv.org/abs/2605.27583 · HTML: https://mlsanity.com/paper/2605.27583/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 32 of its 46 references that are in the map.
- First posted on arXiv 26 May 2026.

## Builds on (most cited first, 30 of 32)

- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Learning deep representations by mutual information estimation and maximization](https://mlsanity.com/paper/1808.06670/) (2018)
- [Deep Learning and the Information Bottleneck Principle](https://mlsanity.com/paper/1503.02406/) (2015)
- [MedCPT: Contrastive Pre-trained Transformers with Large-scale PubMed Search Logs for Zero-shot Biomedical Information Retrieval](https://mlsanity.com/paper/2307.00589/) (2023)
- [CLOCS: Contrastive Learning of Cardiac Signals Across Space, Time, and Patients](https://mlsanity.com/paper/2005.13249/) (2020)
- [Med-R1: Reinforcement Learning for Generalizable Medical Reasoning in Vision-Language Models](https://mlsanity.com/paper/2503.13939/) (2025)
- [Self-supervised ECG Representation Learning for Emotion Recognition](https://mlsanity.com/paper/2002.03898/) (2020)
- [ECG-FM: An Open Electrocardiogram Foundation Model](https://mlsanity.com/paper/2408.05178/) (2024)
- [Guiding Masked Representation Learning to Capture Spatio-Temporal Relationship of Electrocardiogram](https://mlsanity.com/paper/2402.09450/) (2024)
- [Self-supervised representation learning from 12-lead ECG data](https://mlsanity.com/paper/2103.12676/) (2021)
- [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)
- [Self-Supervised Time Series Representation Learning via Cross Reconstruction Transformer](https://mlsanity.com/paper/2205.09928/) (2022)
- [ECG-Chat: A Large ECG-Language Model for Cardiac Disease Diagnosis](https://mlsanity.com/paper/2408.08849/) (2024)
- [QoQ-Med: Building Multimodal Clinical Foundation Models with Domain-Aware GRPO Training](https://mlsanity.com/paper/2506.00711/) (2025)
- [3KG: Contrastive Learning of 12-Lead Electrocardiograms using Physiologically-Inspired Augmentations](https://mlsanity.com/paper/2106.04452/) (2021)
- [Reading Your Heart: Learning ECG Words and Sentences via Pre-training ECG Language Model](https://mlsanity.com/paper/2502.10707/) (2025)
- [ECG Semantic Integrator (ESI): A Foundation ECG Model Pretrained with LLM-Enhanced Cardiological Text](https://mlsanity.com/paper/2405.19366/) (2024)
- [Learning General Representation of 12-Lead Electrocardiogram with a Joint-Embedding Predictive Architecture](https://mlsanity.com/paper/2410.08559/) (2024)
- [Boosting Masked ECG-Text Auto-Encoders as Discriminative Learners](https://mlsanity.com/paper/2410.02131/) (2024)
- [From Token to Rhythm: A Multi-Scale Approach for ECG-Language Pretraining](https://mlsanity.com/paper/2506.21803/) (2025)
- [Self-Supervised Pre-Training with Joint-Embedding Predictive Architecture Boosts ECG Classification Performance](https://mlsanity.com/paper/2410.13867/) (2024)
- [Towards Enhancing Time Series Contrastive Learning: A Dynamic Bad Pair Mining Approach](https://mlsanity.com/paper/2302.03357/) (2023)
- [Aligning Multimodal Representations through an Information Bottleneck](https://mlsanity.com/paper/2506.04870/) (2025)
- [Analysis of Augmentations for Contrastive ECG Representation Learning](https://mlsanity.com/paper/2206.07656/) (2022)
- [LightX3ECG: A Lightweight and eXplainable Deep Learning System for 3-lead Electrocardiogram Classification](https://mlsanity.com/paper/2207.12381/) (2022)
- [Global ECG Classification by Self-Operational Neural Networks with Feature Injection](https://mlsanity.com/paper/2204.03768/) (2022)
- [ECG-Byte: A Tokenizer for End-to-End Generative Electrocardiogram Language Modeling](https://mlsanity.com/paper/2412.14373/) (2024)
- [A Multi-Resolution Mutual Learning Network for Multi-Label ECG Classification](https://mlsanity.com/paper/2406.16928/) (2024)

## Abstract (arXiv)

Electrocardiograms (ECGs) are widely used non-invasive measurements of cardiac activity and play a central role in clinical diagnosis. Recent multimodal approaches align ECG signals with clinical reports to incorporate diagnostic semantics, but clinical reports often fail to preserve the rich physiological structure of ECG waveforms, particularly across multiple levels of abstraction ranging from coarse diagnostic categories to fine-grained morphology. To address this limitation, we formulate ECG representation learning from an information-theoretic perspective and derive a tractable objective that jointly preserves signal structure and integrates clinical semantics. Based on this principle, we propose MERIT (Multimodal ECG Representation via Information Theory), a dual-branch pretraining framework combining masked ECG modeling with ECG--text contrastive alignment. Extensive experiments on PTB-XL and additional benchmarks demonstrate consistent improvements over prior methods, including gains exceeding 3% F1 on PTB-XL All and 5% F1 on SubClass classification. In zero-shot evaluation, MERIT further improves performance by up to  +2.66% AUC and  +2.11% F1 on PTB-XL SubClass, while also demonstrating robustness under multiple distribution-shift settings. Moreover, leveraging the learned ECG representations for ECG-conditioned clinical text generation with large language models improves text quality across several metrics, including ROUGE and METEOR. Together, these results demonstrate that MERIT learns more informative and clinically meaningful ECG representations, particularly for fine-grained clinical applications.