High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Training

• URL: http://arxiv.org/abs/2510.05492v2
• Date: Thu, 09 Oct 2025 00:47:14 GMT
• Title: High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Training
• Authors: Zhuoyi Huang, Nutan Sahoo, Anamika Kumari, Girish Kumar, Kexuan Cai, Shixing Cao, Yue Kang, Tian Xia, Somya Chatterjee, Nicholas Hausman, Aidan Jay, Eric S. Rosenthal, Soundar Srinivasan, Sadid Hasan, Alex Fedorov, Sulaiman Vesal,
• Abstract summary: Development of machine learning for cardiac care is hampered by privacy restrictions on sharing real patient electrocardiogram (ECG) data.<n>In this work, we address two major shortcomings of current generative ECG methods.<n>We build on a conditional diffusion-based Structured State Space Model (SSSD-ECG) with two principled innovations.
• Score: 3.864395218585964
• License: http://creativecommons.org/licenses/by/4.0/
• Abstract: The development of machine learning for cardiac care is severely hampered by privacy restrictions on sharing real patient electrocardiogram (ECG) data. Although generative AI offers a promising solution, the real-world use of existing model-synthesized ECGs is limited by persistent gaps in trustworthiness and clinical utility. In this work, we address two major shortcomings of current generative ECG methods: insufficient morphological fidelity and the inability to generate personalized, patient-specific physiological signals. To address these gaps, we build on a conditional diffusion-based Structured State Space Model (SSSD-ECG) with two principled innovations: (1) MIDT-ECG (Mel-Spectrogram Informed Diffusion Training), a novel training paradigm with time-frequency domain supervision to enforce physiological structural realism, and (2) multi-modal demographic conditioning to enable patient-specific synthesis. We comprehensively evaluate our approach on the PTB-XL dataset, assessing the synthesized ECG signals on fidelity, clinical coherence, privacy preservation, and downstream task utility. MIDT-ECG achieves substantial gains: it improves morphological coherence, preserves strong privacy guarantees with all metrics evaluated exceeding the baseline by 4-8%, and notably reduces the interlead correlation error by an average of 74%, while demographic conditioning enhances signal-to-noise ratio and personalization. In critical low-data regimes, a classifier trained on datasets supplemented with our synthetic ECGs achieves performance comparable to a classifier trained solely on real data. Together, we demonstrate that ECG synthesizers, trained with the proposed time-frequency structural regularization scheme, can serve as personalized, high-fidelity, privacy-preserving surrogates when real data are scarce, advancing the responsible use of generative AI in healthcare.

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