# ATRIA: Adaptive Traceable ECG Reporting with Iterative Agents

arXiv: https://arxiv.org/abs/2606.24392 · HTML: https://mlsanity.com/paper/2606.24392/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 24 references that are in the map.
- First posted on arXiv 23 Jun 2026.

## Builds on (most cited first, 7 of 7)

- [Automatic diagnosis of the 12-lead ECG using a deep neural network](https://mlsanity.com/paper/1904.01949/) (2019)
- [GEM: Empowering MLLM for Grounded ECG Understanding with Time Series and Images](https://mlsanity.com/paper/2503.06073/) (2025)
- [MEIT: Multimodal Electrocardiogram Instruction Tuning on Large Language Models for Report Generation](https://mlsanity.com/paper/2403.04945/) (2024)
- [Electrocardiogram Report Generation and Question Answering via Retrieval-Augmented Self-Supervised Modeling](https://mlsanity.com/paper/2409.08788/) (2024)
- [ECG-Agent: On-Device Tool-Calling Agent for ECG Multi-Turn Dialogue](https://mlsanity.com/paper/2601.20323/) (2026)
- [CARE-ECG: Causal Agent-based Reasoning for Explainable and Counterfactual ECG Interpretation](https://mlsanity.com/paper/2604.10420/) (2026)
- [ALFRED: Ask a Large-language model For Reliable ECG Diagnosis](https://mlsanity.com/paper/2505.03781/) (2025)

## Abstract (arXiv)

Existing ECG report generation is tightly coupled -- interpretation and reporting fused end-to-end, so errors propagate without stage-level recourse -- while agent-based systems decouple tasks but remain single-pass, never revisiting earlier outputs. Clinical ECG reporting instead unfolds iteratively, requiring progressive context integration and bidirectional editing. We present textscATRIA, a multi-agent ECG reporting system that mirrors the clinician's iterative workflow: it binds every report claim to its supporting evidence, flags statements unsupported by that evidence, incorporates additional context mid-session, and lets clinicians verify and revise individual findings rather than accept one opaque output. Because its agents use ECG analysis models already in clinical use, the underlying findings are clinically trustworthy; and as a cloud-based web service, textscATRIA is ready for immediate deployment. We demonstrate textscATRIA through four interaction cases, with a live demo and video available.