Abstract: Cardiovascular diseases are a major global health challenge, with electrocardiography (ECG) being critical for diagnosis and monitoring. As artificial intelligence and automated ECG diagnostic technologies rapidly advance, the demand for large-scale ECG databases continues to grow. Generative ECG has become a mainstream method to enhance database size and diversity. However, existing methods typically generate ECG randomly or focus on limited physiological categories, lacking the ability to synthesize ECG with varying physiological features and cardiac cycles, which is crucial for various practical applications. In response to this need, we propose a novel approach introducing a diffusion model called DIFF-ECG to generate precisely customized ECG that accurately reflect diverse cardiac conditions. Segmentation-based quality assessments confirmed that the synthesized ECG accurately followed the specified cardiac cycle information, with our model significantly outperforming baseline diffusion and GAN-based methods. Therefore, our approach addresses the critical need for generating clinically relevant and customizable ECG, contributing significantly to the field of automated cardiac disease diagnosis. By enabling fine-tuning of cardiac cycle phases, our method significantly expands the application range of generative ECG, potentially improving the diagnostic accuracy for rare diseases and advancing personalized medicine.
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