# ECG Foundation Model

ECG foundation models are usually compared on in-domain interpretation tasks, leaving their transfer to longitudinal prognosis across healthcare systems uncertain. PACE-ECG treats two recordings from the same patient within 60 days as a contrastive positive pair and adds waveform- and report-derived multitask supervision, with an encoder of 2.21 million parameters. On MIMIC-IV and two external HEEDB cohorts, its frozen representations predict post-myocardial-infarction all-cause mortality and incident heart failure with higher AUROC than DeepECG-SSL, with the largest gains in external heart failure.

ECG foundation models are usually compared on in-domain interpretation tasks, leaving their transfer to longitudinal prognosis across healthcare systems uncertain. PACE-ECG treats two recordings from the same patient within 60 days as a contrastive positive pair and adds waveform- and report-derived multitask supervision, with an encoder of 2.21 million parameters. On MIMIC-IV and two external HEEDB cohorts, its frozen representations predict post-myocardial-infarction all-cause mortality and incident heart failure with higher AUROC than DeepECG-SSL, with the largest gains in external heart failure.