# BeatGraph: Self-Supervised Heartbeat Graphs for Infant ECG Representations from the Home Environment

arXiv: https://arxiv.org/abs/2609.31546 · HTML: https://mlsanity.com/paper/2609.31546/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 22 of its 41 references that are in the map.
- First posted on arXiv 25 Sep 2026.

## Builds on (most cited first, 22 of 22)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
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- [A Time Series is Worth 64 Words: Long-term Forecasting with Transformers](https://mlsanity.com/paper/2211.14730/) (2022)
- [An Empirical Study of Training Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.02057/) (2021)
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- [A Transformer-based Framework for Multivariate Time Series Representation Learning](https://mlsanity.com/paper/2010.02803/) (2020)
- [CLOCS: Contrastive Learning of Cardiac Signals Across Space, Time, and Patients](https://mlsanity.com/paper/2005.13249/) (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)
- [Lead-agnostic Self-supervised Learning for Local and Global Representations of Electrocardiogram](https://mlsanity.com/paper/2203.06889/) (2022)
- [A Large Collection of Real-world Pediatric Sleep Studies](https://mlsanity.com/paper/2102.13284/) (2021)
- [Graph Neural Networks for Topological Feature Extraction in ECG Classification](https://mlsanity.com/paper/2311.04228/) (2023)
- [TolerantECG: A Foundation Model for Imperfect Electrocardiogram](https://mlsanity.com/paper/2507.09887/) (2025)
- [Leveraging Visibility Graphs for Enhanced Arrhythmia Classification with Graph Convolutional Networks](https://mlsanity.com/paper/2404.15367/) (2024)
- [Arrhythmia Classification Using Graph Neural Networks Based on Correlation Matrix](https://mlsanity.com/paper/2410.10758/) (2024)

## Abstract (arXiv)

Electrocardiogram (ECG) foundation models typically tokenize the signal into fixed-length patches that ignore cardiac structure, so a patch may split a heartbeat and the number of beats in each patch shifts with heart rate. This matters most for infants, whose heart rates are higher and whose ECG differs from the adult, clinic-recorded 12-lead data these models are built on. A model for infant ECG should therefore reason about heartbeats directly rather than recover them from arbitrary patches. We propose BeatGraph, which makes the heartbeat its unit of representation, modeling each 30-second window as a graph of beats. A shared beat encoder embeds each heartbeat from its waveform and inter-beat intervals, a Transformer with positional encoding orders the beats in time, and residual graph attention layers relate every beat to every other before attention pooling yields a window embedding. We pretrain BeatGraph on our new corpus of unlabeled infant recordings by predicting masked-beat embeddings, then fine-tune it for each task. One backbone supports sleep-wake detection, infant-state classification, activity-source identification (infant- or caregiver-initiated movement), and affect recognition, improving macro-F1 over the strongest baseline on each task by 0.076 to 0.158. It also transfers across age groups, reaching 0.892 AUROC on the ZZU-pECG pediatric benchmark (ages 0 to 14), within 0.001 of the best published self-supervised ECG model, and matching that model under linear evaluation on the adult PTB-XL benchmark despite infant-only pretraining. Finally, to our knowledge, we release the first public infant ECG corpus collected in homes, classrooms, and laboratory settings with state and affect labels. It contains 3,408 hours of single-channel ECG from 143 infants aged 3 to 11 months, with unlabeled pretraining data, benchmark tasks, and subject-level splits.