Q-Heart: ECG Question Answering via Knowledge-Informed Multimodal LLMs

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Main Authors: Pham, Hung Manh, Tang, Jialu, Saeed, Aaqib, Ma, Dong
Format: Preprint
Published: 2025
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author Pham, Hung Manh
Tang, Jialu
Saeed, Aaqib
Ma, Dong
author_facet Pham, Hung Manh
Tang, Jialu
Saeed, Aaqib
Ma, Dong
contents Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.
format Preprint
id arxiv_https___arxiv_org_abs_2505_06296
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Q-Heart: ECG Question Answering via Knowledge-Informed Multimodal LLMs
Pham, Hung Manh
Tang, Jialu
Saeed, Aaqib
Ma, Dong
Signal Processing
Electrocardiography (ECG) offers critical cardiovascular insights, such as identifying arrhythmias and myocardial ischemia, but enabling automated systems to answer complex clinical questions directly from ECG signals (ECG-QA) remains a significant challenge. Current approaches often lack robust multimodal reasoning capabilities or rely on generic architectures ill-suited for the nuances of physiological signals. We introduce Q-Heart, a novel multimodal framework designed to bridge this gap. Q-Heart leverages a powerful, adapted ECG encoder and integrates its representations with textual information via a specialized ECG-aware transformer-based mapping layer. Furthermore, Q-Heart leverages dynamic prompting and retrieval of relevant historical clinical reports to guide tuning the language model toward knowledge-aware ECG reasoning. Extensive evaluations on the benchmark ECG-QA dataset show Q-Heart achieves state-of-the-art performance, outperforming existing methods by a 4% improvement in exact match accuracy. Our work demonstrates the effectiveness of combining domain-specific architectural adaptations with knowledge-augmented LLM instruction tuning for complex physiological ECG analysis, paving the way for more capable and potentially interpretable clinical patient care systems.
title Q-Heart: ECG Question Answering via Knowledge-Informed Multimodal LLMs
topic Signal Processing
url https://arxiv.org/abs/2505.06296