Self-Alignment Learning to Improve Myocardial Infarction Detection from Single-Lead ECG

Abstract

Myocardial infarction is a critical manifestation of coronary artery disease, yet detecting it from single-lead electrocardiogram (ECG) remains challenging due to limited spatial information. An intuitive idea is to convert single-lead into multiple-lead ECG for classification by pre-trained models, but generative methods optimized at the signal level in most cases leave a large latent space gap, ultimately degrading diagnostic performance. This naturally raises the question of whether latent space alignment could help. However, most prior ECG alignment methods focus on learning transformation invariance, which mismatches the goal of single-lead detection. To address this issue, we propose SelfMIS, a simple yet effective alignment learning framework to improve myocardial infarction detection from single-lead ECG. Discarding manual data augmentations, SelfMIS employs a self-cutting strategy to pair multiple-lead ECG with their corresponding single-lead segments and directly align them in the latent space. This design shifts the learning objective from pursuing transformation invariance to enriching the single-lead representation, explicitly driving the single-lead ECG encoder to learn a representation capable of inferring global cardiac context from the local signal. Experimentally, SelfMIS achieves superior performance over baseline models across nine myocardial infarction types while maintaining a simpler architecture and lower computational overhead, thereby substantiating the efficacy of direct latent space alignment. Our code and checkpoint will be publicly available after acceptance.