A hybrid CNN-SSM-Attention backbone for 12-lead ECG classification is introduced, which provides strong supervised baselines under a compact parameter budget and improves transfer, particularly in reduced-label settings and under both full fine-tuning and LoRA-based adaptation.
Abstract
Automatic 12-lead electrocardiogram (ECG) classification requires representations that jointly capture local waveform morphology, long-range temporal dynamics, and cross-lead dependencies, yet integrating these properties within a single efficient architecture remains challenging. This paper introduces a hybrid CNN-SSM-Attention backbone for 12-lead ECG classification. A convolutional stem performs early waveform tokenization and temporal reduction, mixed state-space and depthwise-convolutional blocks model temporal dynamics and local morphology, and a late self-attention stage enables global token interaction at reduced resolution. To improve transfer from unlabeled data, we further develop an ECG-oriented Joint-Embedding Predictive Pretraining (JEPA) framework. Unlike ViT-based JEPA methods that mask patch tokens before the encoder, the proposed method samples span masks at the latent temporal resolution and projects them back to the waveform domain, then predicts clean latent targets from a momentum encoder without waveform reconstruction. Experiments on CPSC2018, Chapman-Shaoxing, and PTB-XL, with pretraining on approximately 350K unlabeled CODE-15 recordings, show that the proposed backbone provides strong supervised baselines under a compact parameter budget. JEPA pretraining further improves transfer, particularly in reduced-label settings and under both full fine-tuning and LoRA-based adaptation. Code: https://github.com/yakoubbazi/Hybrid_ECG_Jepa
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