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This study demonstrates that self-supervised pretraining enables a deep learning model to outperform established commercial and open-source ECG delineation tools while reducing reliance on costly expert annotations. By benchmarking across multiple datasets, the research provides concrete evidence that label-efficient strategies can achieve superior accuracy in identifying waveform boundaries, even when degrading less from normal sinus rhythms to complex arrhythmias. These findings offer practical guidance for deploying more robust AI models in diverse clinical settings without requiring massive labeled datasets.
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Label-Efficient Deep Learning for ECG Delineation: A Multi-Dataset Benchmark against Widely Used Delineation Tools

arXiv3 min read

arXiv:2610.07885v1 Announce Type: new Abstract: Electrocardiogram (ECG) delineation, the identification of waveform boundaries, is a foundational step that translates raw ECG signals into clinically interpretable measurements. Deep learning has advanced this task but remains dependent on costly expert annotations. Label-efficient strategies such as self-supervised pretraining and semi-supervised learning are expected to ease this burden, yet it remains unclear whether they yield reliable delineation and whether the deep models they produce outperform the delineation tools used in practice. We address this in two stages. First, comparing self-supervised objectives with supervised or semi-supervised fine-tuning across one internal and four external datasets, we find that pretraining helps but the objective matters, and that the value of semi-supervised fine-tuning depends on the pretraining objective. Second, we benchmark the selected deep learning model against widely used open-source (NeuroKit2, Prominence, ECGdeli) and commercial (CalECG) tools using three complementary metrics. The model ranks best on every metric and dataset, outperforming the strongest tool by a clear margin on the rhythm-diverse set (mIoU 71.3 vs. 54.8%; averaged point-wise sensitivity 92.6 vs. 76.4%), and degrades the least from sinus to arrhythmia. A rhythm-stratified and point-wise analysis further characterizes the distinctive behavior of each tool, yielding practical guidance for tool selection. These results provide systematic, multi-dataset evidence that self-supervised pretraining is effective for ECG delineation and enables a label-efficiently trained deep learning model to outperform widely used delineation tools by leveraging abundant unlabeled data. This supports adopting such models in diverse, real-world clinical settings.

Abstract:Electrocardiogram (ECG) delineation, the identification of waveform boundaries, is a foundational step that translates raw ECG signals into clinically interpretable measurements. Deep learning has advanced this task but remains dependent on costly expert annotations. Label-efficient strategies such as self-supervised pretraining and semi-supervised learning are expected to ease this burden, yet it remains unclear whether they yield reliable delineation and whether the deep models they produce outperform the delineation tools used in practice. We address this in two stages. First, comparing self-supervised objectives with supervised or semi-supervised fine-tuning across one internal and four external datasets, we find that pretraining helps but the objective matters, and that the value of semi-supervised fine-tuning depends on the pretraining objective. Second, we benchmark the selected deep learning model against widely used open-source (NeuroKit2, Prominence, ECGdeli) and commercial (CalECG) tools using three complementary metrics. The model ranks best on every metric and dataset, outperforming the strongest tool by a clear margin on the rhythm-diverse set (mIoU 71.3 vs. 54.8%; averaged point-wise sensitivity 92.6 vs. 76.4%), and degrades the least from sinus to arrhythmia. A rhythm-stratified and point-wise analysis further characterizes the distinctive behavior of each tool, yielding practical guidance for tool selection. These results provide systematic, multi-dataset evidence that self-supervised pretraining is effective for ECG delineation and enables a label-efficiently trained deep learning model to outperform widely used delineation tools by leveraging abundant unlabeled data. This supports adopting such models in diverse, real-world clinical settings.

20 pages, 5 figures. First two authors contributed equally

Machine Learning (cs.LG); Artificial Intelligence (cs.AI); Computer Vision and Pattern Recognition (cs.CV); Signal Processing (eess.SP)

arXiv:2610.07885 [cs.LG]

(or arXiv:2610.07885v1 [cs.LG] for this version)

https://doi.org/10.48550/arXiv.2610.07885 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 354 words

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