ELOGOnet: Knowledge-enhanced local-global learning for cardiac diagnosis

Abstract

The diagnostic process of a human cardiologist is a holistic act of reasoning that seamlessly integrates two key components: (1) a synergistic analysis of the ECG signal itself, combining insights from both global rhythmic patterns and local morphologies; and (2) a prior-informed interpretation process that leverages internalized medical priors and external patient-specific information. However, existing deep learning models struggle to emulate this complex expert reasoning, often facing a dual dilemma: a failure to synergize local and global features within a unified framework, and a widespread neglect of valuable, low-cost prior knowledge sources like disease associations and patient metadata. To bridge this gap, we propose ELOGOnet, a novel deep learning framework designed to model the expert diagnostic workflow. Modeling the expert’s synergistic signal analysis, ELOGOnet employs a parallel hybrid architecture that integrates a State Space Model (SSM) for global rhythms and a CNN for local morphologies. Enabling a prior-informed interpretation, the framework incorporates two key innovations: an association loss that enhances clinical coherence by modeling disease comorbidity and mutual exclusivity, and an adaptive cross-gating module for the robust fusion of patient metadata. Extensive experiments on several mainstream public benchmarks demonstrate that ELOGOnet establishes a new state-of-the-art by achieving an average Macro-F1 of 63.8% across 8 multi-label tasks and consistently outperforming 16 competitive baselines, thereby setting a new performance benchmark for automated cardiac diagnosis from ECG.