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Melgarejo-Meseguerb, Francisco ManuelAuthorRojo-Alvarez, Jose LuisAuthor

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October 14, 2025
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Article

Active learning in latent spaces for long-term ECG monitoring: Morphology and rhythm analysis

Publicated to: Biomedical Signal Processing and Control. 112 108622- - 2026-09-12 112(), DOI: 10.1016/j.bspc.2025.108622

Authors:

Holgado-Cuadrado, R; Plaza-Seco, C; Melgarejo-Meseguerb, FM; Rojo-Alvarez, JL; Blanco-Velasco, M
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Affiliations

Alcala Univ, Dept Signal Theory & Commun, Madrid 28805, Spain - Author
Rey Juan Carlos Univ, Dept Signal Theory & Commun & Telematic Syst & Co, Madrid, Spain - Author

Abstract

Electrocardiogram (ECG) processing systems based on deep learning offer potential for advanced cardiac analysis. However, these systems often encounter significant challenges, such as the scarcity of labeled data, which affects their performance, reliability, and integration into clinical practice. This study aims to address these challenges by proposing an Active Learning (AL) methodology to optimize data labeling, reducing annotation effort while improving model performance. We evaluate the AL approach across three distinct applications: (1) sinus rhythm beat classification using synthetic data; (2) clinical severity of noise classification with a long-term ECG monitoring repository acquired under real conditions; and (3) cardiac wave delineation using a gold-standard dataset with expert annotations from the publicly available PhysioNet QT Database (QTDB) and the Lobachevsky University ECG Database (LUDB). In each classification task, our proposed AL framework integrates a neural network based on an autoencoder that generates a visualizable latent space for explainability into the decision-making process. The system iteratively selects the most informative instances using a margin sampling strategy in the latent space and incorporates them into the training process to refine performance. Results demonstrate that the AL approach consistently outperforms random sample selection in precision, recall, and F1-score. Additionally, ECG in-line analysis shows that models trained with the AL strategy outperform those from previous studies, even when trained on smaller subsets of the experimental datasets. This approach can reduce the labeling workload of clinicians, helping to efficiently increase labeled data, improve model performance, foster confidence in decision support systems, and advance ECG analysis applications.
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Keywords

Active learning (al)Deep learning (dl)Electrocardiogram (ecg)

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Biomedical Signal Processing and Control due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2026, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Signal Processing.

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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 9 (PlumX).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: http://hdl.handle.net/10017/66134
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Project objectives

Los objetivos perseguidos en esta aportación se centran en mejorar el análisis avanzado del electrocardiograma (ECG) mediante aprendizaje activo en espacios latentes. Se busca: analizar la eficacia de una metodología de Active Learning (AL) para optimizar el etiquetado de datos y reducir el esfuerzo de anotación; evaluar el desempeño del enfoque AL en la clasificación de latidos de ritmo sinusal con datos sintéticos; determinar la capacidad para clasificar la severidad clínica del ruido en registros ECG de larga duración bajo condiciones reales; caracterizar la delineación de ondas cardíacas utilizando bases de datos estándar con anotaciones expertas; y validar que el sistema basado en autoencoders y muestreo por margen mejora la precisión, recall y F1-score frente a selecciones aleatorias, facilitando la integración clínica y la confianza en sistemas de soporte a la decisión.
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Most relevant results

Los resultados más relevantes del estudio evidencian la eficacia del método de aprendizaje activo (AL) propuesto para el análisis de ECG a largo plazo. En primer lugar, la clasificación de latidos en ritmo sinusal con datos sintéticos mostró mejoras significativas en precisión, recall y F1-score respecto a la selección aleatoria de muestras. En segundo lugar, la clasificación clínica de la severidad del ruido en un repositorio de ECG bajo condiciones reales confirmó la superioridad del enfoque AL. En tercer lugar, la delineación de ondas cardíacas utilizando bases de datos estándar (QTDB y LUDB) demostró que el sistema basado en autoencoders y muestreo por margen optimiza el rendimiento con menos datos etiquetados, reduciendo la carga de anotación y superando modelos previos.
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Awards linked to the item

This work has been partially supported by the research project grants PRE FPU-UAH-21 and PRE FPI-UAH-23 from the University of Alcala, Spain, as well as FPI-CAM-23 from the Comunidad de Madrid, Spain. Additionally, it has received funding from the grants PID2022-140786NB-C32 and PID2023-152331OA-I00, provided by MCIN/AEI/10.13039/501100011033 through the Spanish Ministry of Science and Innovation, Spain.
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