Joseph Barker

Ahcène Boubekki, Konstantinos Patlatzoglou, Joseph Barker et al.

Deep learning has significantly advanced electrocardiogram (ECG) analysis, enabling automatic annotation, disease screening, and prognosis beyond traditional clinical capabilities. However, understanding these models remains a challenge, limiting interpretation and gaining knowledge from these developments. In this work, we propose a novel interpretability method for convolutional neural networks applied to ECG analysis. Our approach extracts time-localized clusters from the model's internal representations, segmenting the ECG according to the learned characteristics while quantifying the uncertainty of these representations. This allows us to visualize how different waveform regions contribute to the model's predictions and assess the certainty of its decisions. By providing a structured and interpretable view of deep learning models for ECG, our method enhances trust in AI-driven diagnostics and facilitates the discovery of clinically relevant electrophysiological patterns.

Gul Rukh Khattak, Konstantinos Patlatzoglou, Joseph Barker et al.

Contrastive learning is a widely adopted self-supervised pretraining strategy, yet its dependence on cohort composition remains underexplored. We present Contrasting by Patient Augmented Electrocardiograms (CAPE) foundation model and pretrain on four cohorts (n = 5,203,352), from diverse populations across three continents (North America, South America, Asia). We systematically assess how cohort demographics, health status, and population diversity influence the downstream performance for prediction tasks also including two additional cohorts from another continent (Europe). We find that downstream performance depends on the distributional properties of the pretraining cohort, including demographics and health status. Moreover, while pretraining with a multi-centre, demographically diverse cohort improves in-distribution accuracy, it reduces out-of-distribution (OOD) generalisation of our contrastive approach by encoding cohort-specific artifacts. To address this, we propose the In-Distribution Batch (IDB) strategy, which preserves intra-cohort consistency during pretraining and enhances OOD robustness. This work provides important insights for developing clinically fair and generalisable foundation models.

Alexander Jenkins, Andrea Cini, Joseph Barker et al.

Catheter ablation of Atrial Fibrillation (AF) consists of a one-size-fits-all treatment with limited success in persistent AF. This may be due to our inability to map the dynamics of AF with the limited resolution and coverage provided by sequential contact mapping catheters, preventing effective patient phenotyping for personalised, targeted ablation. Here we introduce FibMap, a graph recurrent neural network model that reconstructs global AF dynamics from sparse measurements. Trained and validated on 51 non-contact whole atria recordings, FibMap reconstructs whole atria dynamics from 10% surface coverage, achieving a 210% lower mean absolute error and an order of magnitude higher performance in tracking phase singularities compared to baseline methods. Clinical utility of FibMap is demonstrated on real-world contact mapping recordings, achieving reconstruction fidelity comparable to non-contact mapping. FibMap's state-spaces and patient-specific parameters offer insights for electrophenotyping AF. Integrating FibMap into clinical practice could enable personalised AF care and improve outcomes.