ExpertoRhythm: Morphology-Aware Learning for Waveform Reconstruction and Cuffless Blood Pressure Estimation from Single-Channel PPG

Amir Arjomand, Kenneth B. Kent, Georgiy Krylov

Continuous cuffless blood pressure (BP) monitoring from photoplethysmography (PPG) has strong potential for wearable health and telemonitoring, but accurate estimation remains difficult because PPG-to-BP mapping must preserve subtle waveform morphology and pressure-range-dependent dynamics. We introduce ExpertoRhythm, an attention-enhanced 1D U-Net that reconstructs the arterial blood pressure (ABP) waveform from a single-channel PPG signal and derives systolic and diastolic BP directly from the reconstructed waveform. The central contribution is a composite morphology-aware learning objective that integrates range-weighted SmoothL1 reconstruction with a window-range regularizer to emphasize high-dynamic BP segments and reduce amplitude under/over-shoot. On the UCI cuff-less BP dataset with 942 subjects, ExpertoRhythm achieves 2.46/1.46 mmHg MAE for systolic/diastolic BP (SBP/DBP), while obtaining a 30.4% average relative error reduction over pure MSE across waveform reconstruction and BP estimation metrics. Clinical-style evaluation further demonstrates low bias and strong agreement across the BP range, including high-pressure windows up to 200 mmHg, satisfying AAMI criteria and…