MSAIC-Net: A Multi-Scale Attention and Imbalance-Aware Contrastive Network for ECG-Based Myocardial Substrate Abnormality Detection

• URL: http://arxiv.org/abs/2606.06718v1
• Date: Thu, 04 Jun 2026 21:08:06 GMT
• Title: MSAIC-Net: A Multi-Scale Attention and Imbalance-Aware Contrastive Network for ECG-Based Myocardial Substrate Abnormality Detection
• Abstract summary: Myocardial substrate abnormalities, such as myocardial scar and myocardial infarction (MI), are associated with adverse cardiovascular outcomes.<n>We propose a multi-scale attention-enhanced convolutional network (MSAIC-Net) for ECG-based myocardial substrate abnormality detection.<n>MSAIC-Net employs parallel atrous convolutional branches to extract ECG features across multiple temporal receptive fields.
• Score: 1.1242503819703258
• License: http://arxiv.org/licenses/nonexclusive-distrib/1.0/
• Abstract: Myocardial substrate abnormalities, such as myocardial scar and myocardial infarction (MI), are associated with adverse cardiovascular outcomes. Electrocardiography (ECG) provides a low-cost and widely available tool for detecting these abnormalities, but ECG-based detection remains challenging due to heterogeneous lead-dependent manifestations, high-dimensional multi-lead signals, class imbalance, and the limited interpretability of deep learning models. We propose a multi-scale attention-enhanced convolutional network (MSAIC-Net) for ECG-based myocardial substrate abnormality detection. MSAIC-Net employs parallel atrous convolutional branches to extract ECG features across multiple temporal receptive fields. %, enabling the model to capture both local and longer-range temporal patterns. Channel attention is then used to adaptively reweight informative lead-wise and feature-channel representations. To address class imbalance and improve feature separability, we introduce a novel imbalance-aware supervised contrastive learning strategy that encourages samples from the same class to form compact representations while increasing separation between abnormal and normal samples. Lead-wise permutation importance is further incorporated to quantify the contribution of each ECG lead and improve model interpretability. The proposed method was evaluated on two complementary datasets: a low-data institutional cohort from the University of Virginia (UVA) Health System for myocardial scar classification and the large-scale public PTB-XL dataset from PhysioNet for MI identification. Experimental results show that MSAIC-Net outperforms baseline models, with particularly pronounced improvements in the low-data UVA cohort. Overall, the proposed framework provides an effective and interpretable approach for ECG-based detection of myocardial substrate abnormalities.

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