Conditional Electrocardiogram Generation Using Hierarchical Variational Autoencoders

Cardiovascular diseases remain the leading cause of mortality, and automated electrocardiogram (ECG) analysis can ease clinical workloads but is limited by scarce and imbalanced data. Synthetic ECG can mitigate these issues, and while most methods use Generative Adversarial Networks (GANs), recent work show variational autoencoders (VAEs) perform comparably. We introduce cNVAE-ECG, a conditional Nouveau VAE (NVAE) that generates high-resolution, 12-lead, 10-second ECGs with multiple pathologies. Leveraging a compact channel-generation scheme and class embeddings for multi-label conditioning, cNVAE-ECG improves downstream binary and multi-label classification, achieving up to a 2% AUROC gain in transfer learning over GAN-based models.