ECG-IMN: Interpretable Mesomorphic Neural Networks for 12-Lead Electrocardiogram Interpretation

Fuente: arXiv
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Auteurs principaux: Thambawita, Vajira, Isaksen, Jonas L., Kanters, Jørgen K., Hammer, Hugo L., Halvorsen, Pål
Format: Preprint
Publié: 2026
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author Thambawita, Vajira
Isaksen, Jonas L.
Kanters, Jørgen K.
Hammer, Hugo L.
Halvorsen, Pål
author_facet Thambawita, Vajira
Isaksen, Jonas L.
Kanters, Jørgen K.
Hammer, Hugo L.
Halvorsen, Pål
contents Deep learning has achieved expert-level performance in automated electrocardiogram (ECG) diagnosis, yet the "black-box" nature of these models hinders their clinical deployment. Trust in medical AI requires not just high accuracy but also transparency regarding the specific physiological features driving predictions. Existing explainability methods for ECGs typically rely on post-hoc approximations (e.g., Grad-CAM and SHAP), which can be unstable, computationally expensive, and unfaithful to the model's actual decision-making process. In this work, we propose the ECG-IMN, an Interpretable Mesomorphic Neural Network tailored for high-resolution 12-lead ECG classification. Unlike standard classifiers, the ECG-IMN functions as a hypernetwork: a deep convolutional backbone generates the parameters of a strictly linear model specific to each input sample. This architecture enforces intrinsic interpretability, as the decision logic is mathematically transparent and the generated weights (W) serve as exact, high-resolution feature attribution maps. We introduce a transition decoder that effectively maps latent features to sample-wise weights, enabling precise localization of pathological evidence (e.g., ST-elevation, T-wave inversion) in both time and lead dimensions. We evaluate our approach on the PTB-XL dataset for classification tasks, demonstrating that the ECG-IMN achieves competitive predictive performance (AUROC comparable to black-box baselines) while providing faithful, instance-specific explanations. By explicitly decoupling parameter generation from prediction execution, our framework bridges the gap between deep learning capability and clinical trustworthiness, offering a principled path toward "white-box" cardiac diagnostics.
format Preprint
id arxiv_https___arxiv_org_abs_2602_09566
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle ECG-IMN: Interpretable Mesomorphic Neural Networks for 12-Lead Electrocardiogram Interpretation
Thambawita, Vajira
Isaksen, Jonas L.
Kanters, Jørgen K.
Hammer, Hugo L.
Halvorsen, Pål
Machine Learning
Artificial Intelligence
Computer Vision and Pattern Recognition
Methodology
Deep learning has achieved expert-level performance in automated electrocardiogram (ECG) diagnosis, yet the "black-box" nature of these models hinders their clinical deployment. Trust in medical AI requires not just high accuracy but also transparency regarding the specific physiological features driving predictions. Existing explainability methods for ECGs typically rely on post-hoc approximations (e.g., Grad-CAM and SHAP), which can be unstable, computationally expensive, and unfaithful to the model's actual decision-making process. In this work, we propose the ECG-IMN, an Interpretable Mesomorphic Neural Network tailored for high-resolution 12-lead ECG classification. Unlike standard classifiers, the ECG-IMN functions as a hypernetwork: a deep convolutional backbone generates the parameters of a strictly linear model specific to each input sample. This architecture enforces intrinsic interpretability, as the decision logic is mathematically transparent and the generated weights (W) serve as exact, high-resolution feature attribution maps. We introduce a transition decoder that effectively maps latent features to sample-wise weights, enabling precise localization of pathological evidence (e.g., ST-elevation, T-wave inversion) in both time and lead dimensions. We evaluate our approach on the PTB-XL dataset for classification tasks, demonstrating that the ECG-IMN achieves competitive predictive performance (AUROC comparable to black-box baselines) while providing faithful, instance-specific explanations. By explicitly decoupling parameter generation from prediction execution, our framework bridges the gap between deep learning capability and clinical trustworthiness, offering a principled path toward "white-box" cardiac diagnostics.
title ECG-IMN: Interpretable Mesomorphic Neural Networks for 12-Lead Electrocardiogram Interpretation
topic Machine Learning
Artificial Intelligence
Computer Vision and Pattern Recognition
Methodology
url https://arxiv.org/abs/2602.09566