A Hybrid CNN--State-Space--Attention Backbone with Joint-Embedding Predictive Pretraining for 12-Lead ECG Classification

Yakoub Bazi, Sarah Aljuhani, Mohamad M. Al Rahhal, Mansour Zuair, Naif Alajlan

Automatic 12-lead electrocardiogram (ECG) classification requires representations that jointly capture local waveform morphology, long-range temporal dynamics, and cross-lead dependencies, yet integrating these properties within a single efficient architecture remains challenging. This paper introduces a hybrid CNN-SSM-Attention backbone for 12-lead ECG classification. A convolutional stem performs early waveform tokenization and temporal reduction, mixed state-space and depthwise-convolutional blocks model temporal dynamics and local morphology, and a late self-attention stage enables global token interaction at reduced resolution. To improve transfer from unlabeled data, we further develop an ECG-oriented Joint-Embedding Predictive Pretraining (JEPA) framework. Unlike ViT-based JEPA methods that mask patch tokens before the encoder, the proposed method samples span masks at the latent temporal resolution and projects them back to the waveform domain, then predicts clean latent targets from a momentum encoder without waveform reconstruction. Experiments on CPSC2018, Chapman-Shaoxing, and PTB-XL, with pretraining on approximately 350K unlabeled CODE-15 recordings, show that the…