Gespeichert in:
Bibliographische Detailangaben
Hauptverfasser: Huang, Shun, Xing, Wenlu, Geng, Shijia, Wang, Hailong, Nie, Guangkun, Tang, Gongzheng, He, Chenyang, Hong, Shenda
Format: Preprint
Veröffentlicht: 2025
Schlagworte:
Online-Zugang:https://arxiv.org/abs/2510.17172
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
_version_ 1866909857348583424
author Huang, Shun
Xing, Wenlu
Geng, Shijia
Wang, Hailong
Nie, Guangkun
Tang, Gongzheng
He, Chenyang
Hong, Shenda
author_facet Huang, Shun
Xing, Wenlu
Geng, Shijia
Wang, Hailong
Nie, Guangkun
Tang, Gongzheng
He, Chenyang
Hong, Shenda
contents Malignant ventricular arrhythmias (VT/VF) following acute myocardial infarction (AMI) are a major cause of in-hospital death, yet early identification remains a clinical challenge. While traditional risk scores have limited performance, end-to-end deep learning models often lack the interpretability needed for clinical trust. This study aimed to develop a hybrid predictive framework that integrates a large-scale electrocardiogram (ECG) foundation model (ECGFounder) with an interpretable XGBoost classifier to improve both accuracy and interpretability. We analyzed 6,634 ECG recordings from AMI patients, among whom 175 experienced in-hospital VT/VF. The ECGFounder model was used to extract 150-dimensional diagnostic probability features , which were then refined through feature selection to train the XGBoost classifier. Model performance was evaluated using AUC and F1-score , and the SHAP method was used for interpretability. The ECGFounder + XGBoost hybrid model achieved an AUC of 0.801 , outperforming KNN (AUC 0.677), RNN (AUC 0.676), and an end-to-end 1D-CNN (AUC 0.720). SHAP analysis revealed that model-identified key features, such as "premature ventricular complexes" (risk predictor) and "normal sinus rhythm" (protective factor), were highly consistent with clinical knowledge. We conclude that this hybrid framework provides a novel paradigm for VT/VF risk prediction by validating the use of foundation model outputs as effective, automated feature engineering for building trustworthy, explainable AI-based clinical decision support systems.
format Preprint
id arxiv_https___arxiv_org_abs_2510_17172
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Combining ECG Foundation Model and XGBoost to Predict In-Hospital Malignant Ventricular Arrhythmias in AMI Patients
Huang, Shun
Xing, Wenlu
Geng, Shijia
Wang, Hailong
Nie, Guangkun
Tang, Gongzheng
He, Chenyang
Hong, Shenda
Artificial Intelligence
Malignant ventricular arrhythmias (VT/VF) following acute myocardial infarction (AMI) are a major cause of in-hospital death, yet early identification remains a clinical challenge. While traditional risk scores have limited performance, end-to-end deep learning models often lack the interpretability needed for clinical trust. This study aimed to develop a hybrid predictive framework that integrates a large-scale electrocardiogram (ECG) foundation model (ECGFounder) with an interpretable XGBoost classifier to improve both accuracy and interpretability. We analyzed 6,634 ECG recordings from AMI patients, among whom 175 experienced in-hospital VT/VF. The ECGFounder model was used to extract 150-dimensional diagnostic probability features , which were then refined through feature selection to train the XGBoost classifier. Model performance was evaluated using AUC and F1-score , and the SHAP method was used for interpretability. The ECGFounder + XGBoost hybrid model achieved an AUC of 0.801 , outperforming KNN (AUC 0.677), RNN (AUC 0.676), and an end-to-end 1D-CNN (AUC 0.720). SHAP analysis revealed that model-identified key features, such as "premature ventricular complexes" (risk predictor) and "normal sinus rhythm" (protective factor), were highly consistent with clinical knowledge. We conclude that this hybrid framework provides a novel paradigm for VT/VF risk prediction by validating the use of foundation model outputs as effective, automated feature engineering for building trustworthy, explainable AI-based clinical decision support systems.
title Combining ECG Foundation Model and XGBoost to Predict In-Hospital Malignant Ventricular Arrhythmias in AMI Patients
topic Artificial Intelligence
url https://arxiv.org/abs/2510.17172