# Boosting ECG Classification Performance by Pre-training with Synthesized Data

arXiv: https://arxiv.org/abs/2606.10802 · HTML: https://mlsanity.com/paper/2606.10802/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 41 references that are in the map.
- First posted on arXiv 9 Jun 2026.

## Builds on (most cited first, 19 of 19)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Efficiently Modeling Long Sequences with Structured State Spaces](https://mlsanity.com/paper/2111.00396/) (2021)
- [Empirical Evaluation of Gated Recurrent Neural Networks on Sequence Modeling](https://mlsanity.com/paper/1412.3555/) (2014)
- [Learning from Synthetic Humans](https://mlsanity.com/paper/1701.01370/) (2017)
- [Training Deep Networks with Synthetic Data: Bridging the Reality Gap by Domain Randomization](https://mlsanity.com/paper/1804.06516/) (2018)
- [Mega: Moving Average Equipped Gated Attention](https://mlsanity.com/paper/2209.10655/) (2022)
- [Pre-training without Natural Images](https://mlsanity.com/paper/2101.08515/) (2021)
- [Luna: Linear Unified Nested Attention](https://mlsanity.com/paper/2106.01540/) (2021)
- [Medically Aware GPT-3 as a Data Generator for Medical Dialogue Summarization](https://mlsanity.com/paper/2110.07356/) (2021)
- [Label-Free Liver Tumor Segmentation](https://mlsanity.com/paper/2303.14869/) (2023)
- [DermGAN: Synthetic Generation of Clinical Skin Images with Pathology](https://mlsanity.com/paper/1911.08716/) (2019)
- [SimGANs: Simulator-Based Generative Adversarial Networks for ECG Synthesis to Improve Deep ECG Classification](https://mlsanity.com/paper/2006.15353/) (2020)
- [EVA: Generating Longitudinal Electronic Health Records Using Conditional Variational Autoencoders](https://mlsanity.com/paper/2012.10020/) (2020)
- [Data Augmentation for Electrocardiograms](https://mlsanity.com/paper/2204.04360/) (2022)
- [GeoECG: Data Augmentation via Wasserstein Geodesic Perturbation for Robust Electrocardiogram Prediction](https://mlsanity.com/paper/2208.01220/) (2022)
- [General-to-Detailed GAN for Infrequent Class Medical Images](https://mlsanity.com/paper/1812.01690/) (2018)

## Abstract (arXiv)

Deep Neural Networks (DNNs) typically require extensive datasets for effective training. In the medical domain, acquiring large-scale data is often challenging due to privacy concerns and the rarity of certain diseases. To address this data scarcity, we investigate the efficacy of training DNN models using synthetic data, generated based on domain-specific medical knowledge. Specifically, we develop a knowledge-driven Gaussian-composition synthesis algorithm for single-lead II ECGs, in which each heartbeat is represented by Gaussian-shaped P, Q, R, S, and T wave components. Using this simulator, we generate synthetic data for four abnormal electrocardiogram (ECG) classes: atrial fibrillation (AF), atrial flutter (AFLT), premature ventricular complex (PVC), and Wolff-Parkinson-White Syndrome (WPW). We evaluate the utility of this synthetic data by conducting abnormal ECG classification using ten different DNN architectures. Our results demonstrate that synthetic-to-real training improves classification performance for three of the four target abnormalities, with the largest architecture-averaged gain of 33.2% observed for AFLT. Further analysis reveals that the performance enhancement from synthetic data is more pronounced with smaller real-world datasets. These findings suggest that domain-knowledge-based synthetic ECGs can serve as a useful pre-training resource, particularly in scenarios where real-world data are limited or difficult to obtain.