Are ECGs enough? Deep learning classification of cardiac anomalies using only electrocardiograms

Electrocardiography (ECG) is an essential tool for diagnosing multiple cardiac anomalies: it provides valuable clinical insights, while being affordable, fast and available in many settings. However, in the current literature, the role of ECG analysis is often unclear: many approaches either rely on additional imaging modalities, such as Computed Tomography Pulmonary Angiography (CTPA), which may not always be available, or do not effectively generalize across different classification problems. Furthermore, the availability of public ECG datasets is limited and, in practice, these datasets tend to be small, making it essential to optimize learning strategies. In this study, we investigate the performance of multiple neural network architectures in order to assess the impact of various approaches. Moreover, we check whether these practices enhance model generalization when transfer learning is used to translate information learned in larger ECG datasets, such as PTB-XL and CPSC18, to a smaller, more challenging dataset for pulmonary embolism (PE) detection. By leveraging transfer learning, we analyze the extent to which we can improve learning efficiency and predictive performance on limited data. Code available at https://github.com/joaodsmarques/Are-ECGs-enough-Deep-Learning-Classifiers .