High-Fidelity Synthetic ECG Generation via Mel-Spectrogram Informed Diffusion Training
This work addresses privacy restrictions in sharing real patient ECG data for machine learning in healthcare, offering a personalized and high-fidelity synthetic data solution, though it builds incrementally on existing diffusion models.
The paper tackled the problem of generating synthetic electrocardiogram (ECG) data for cardiac care by addressing insufficient morphological fidelity and lack of personalization in existing methods, resulting in improved morphological coherence, privacy metrics exceeding baselines by 4-8%, and a 74% reduction in interlead correlation error.
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.