Cardiovascular diseases (CVDs) are the leading cause of global mortality, and accurate electrocardiogram (ECG) diagnoses are essential for effective clinical interventions. This paper introduces MAR-GCNet, a novel deep learning framework for multi-label ECG anomaly detection that integrates multi-scale feature extraction and inter-class correlation modeling. It combines multi-attention residual networks (MARNs), graph convolutional networks (GCNs) and a weighted fusion strategy. The MARNs incorporate ECA-ResNet blocks with convolutional kernels of sizes 3, 5, and 7 to capture both local and global temporal characteristics in 12-lead ECG signals. The GCNs use a conditional probability matrix (CPM) and a multi-label feature matrix (MLFM) to model inter-class dependencies and mutual exclusivity among cardiac abnormalities. A weighted fusion loss function is employed to integrate the outputs of the MARNs and GCNs branches, enabling optimal multi-label predictions. Experiments on the PTB-XL dataset show that MAR-GCNet outperforms several state-of-the-art (SOTA) models across various annotation levels, achieving the F1 scores of 72.68%, 66.80%, 69.46%, 76.84%, 52.06%, and 90.97% in the “all”, “diag.”, “sub-diag.”, “super-diag.”, “form”, and “rhythm” tasks, respectively. Ablation studies confirm that the integration of multi-scale feature extraction and the two-layer GCN configuration significantly enhance the model performance. These results indicate that MAR-GCNet is a promising approach for accurate and robust automated ECG analysis.
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