Automatic analysis methods of electrocardiograms (ECGs) usually required large-scale annotated training data, but the annotation process is extremely time-consuming. While semi-supervised learning can leverage unlabeled data, its performance depends heavily on the quality of the initial labeled subset. Active learning has been used to identify the most informative samples for annotation, but conventional approaches face three critical limitations: (1) dependency on manual intervention for iterative query design, (2) prohibitive computational costs during sample selection, and (3) limited compatibility with semi-supervised learning frameworks. To address these limitations, we proposed an Unsupervised Active Feature-selective Semi-Supervised Learning (UAFSSL) framework for ECG analysis, including an unsupervised feature selection-based active learning module and a semi-supervised learning module. UAFSSL captures latent data distributions via unsupervised feature extraction, selects diverse and representative samples using pseudo-label clustering, and integrates seamlessly with semi-supervised learning to eliminate human intervention. We validated our algorithm on an ECG waveform segmentation task and an atrial fibrillation detection task. In the waveform segmentation task, our method improved the F1-score for P-wave delineation by 2.4% compared to random sampling, using only 5% of labeled samples. For the atrial fibrillation detection task, we evaluated our method on both the AFDB and a 24-hour dataset collected from 500 atrial fibrillation patients. Using only 200 labeled samples for model training, our method achieved AUC improvements of 2.5% and 2.2% over random sampling in five-fold cross-validation. This is the first study to integrate unsupervised active learning with semi-supervised learning for automatic ECG analysis, offering a robust, automated solution to reduce annotation costs while enhancing clinical applicability.

Electrocardiograms (ECGs) play a critical role in the diagnosis and monitoring of cardiovascular diseases. However, their signal quality is often compromised by various types of noise which can impair diagnostic accuracy and destabilize downstream automated analysis. Recent deep learning-based denoising methods have demonstrated promising results, but they often focus solely on signal reconstruction accuracy while overlooking consistency with downstream tasks, such as waveform segmentation or disease classification. This misalignment may lead to clean-looking signals that are nonetheless structurally misleading or clinically unreliable. To address these limitations, we propose the Task-aware Diffusion Dual-matching (TDD) method, a novel denoising framework that integrates multi-task learning with a modified diffusion process. Unlike conventional multi-task approaches that treat auxiliary tasks as feature enhancers, TDD leverages auxiliary predictions to directly complement and guide the denoising process. Specifically, TDD uses noisy ECG signals as the diffusion starting point to reduce reconstruction uncertainty, and segmentation outputs provide structure-aware gradients that refine the denoising trajectory, which further encourages more confident, unimodal segmentation predictions. This dual-matching process forms a positive feedback loop: cleaner signals enable more accurate segmentation, which in turn reinforces denoising with semantically meaningful guidance. Notably, segmentation labels are not required during inference. Experiments on multiple public ECG datasets show that TDD outperforms existing denoising methods under various noise conditions. Moreover, it exhibits superior structure-preserving capabilities under complex cardiac rhythms and enhances downstream disease diagnosis performance, leading to more accurate clinical interpretation.

The heart sound reflects the movement status of the cardiovascular system and contains the early pathological information of cardiovascular diseases. Automatic heart sound diagnosis plays an essential role in the early detection of cardiovascular diseases. In this study, we aim to develop a novel end-to-end heart sound abnormality detection and classification method, which can be adapted to different heart sound diagnosis tasks. Specifically, we developed a Multi-feature Decision Fusion Network (MDFNet) composed of a Multi-dimensional Feature Extraction (MFE) module and a Multi-dimensional Decision Fusion (MDF) module. The MFE module extracted spatial features, multi-level temporal features and spatial-temporal fusion features to learn heart sound characteristics from multiple perspectives. Through deep supervision and decision fusion, the MDF module made the multi-dimensional features extracted by the MFE module more discriminative, and fused the decision results of multi-dimensional features to integrate complementary information. Furthermore, attention modules were embedded in the MDFNet to emphasize the fundamental heart sounds containing effective feature information. Finally, we proposed an efficient data augmentation method to circumvent the diagnosis performance degradation caused by the lack of cardiac cycle segmentation in other end-to-end methods. The developed method achieved an overall accuracy of 94.44% and a F1-score of 86.90% on the binary classification task and a F1-score of 99.30% on the five-classification task. Our method outperformed other state-of-the-art methods and had good clinical application prospects.

Paroxysmal atrial fibrillation (AF) is generally diagnosed by long-term dynamic electrocardiogram (ECG) monitoring. Identifying AF episodes from long-term ECG data can place a heavy burden on clinicians. Many machine-learning-based automatic AF detection methods have been proposed to solve this issue. However, these methods require numerous annotated data to train the model, and the annotation of AF in long-term ECG is extremely time-consuming. Reducing the demand for labeled data can effectively improve the clinical practicability of automatic AF detection methods. In this study, we developed a novel semi-supervised learning method that generated modified low-entropy labels of unlabeled samples for training a deep learning model to automatically detect paroxysmal AF in 24 h Holter monitoring data. Our method employed a 1D CNN-LSTM neural network with RR intervals as input and used few labeled training data with numerous unlabeled data for training the neural network. This method was evaluated using a 24 h Holter monitoring dataset collected from 1000 paroxysmal AF patients. Using labeled samples from only 10 patients for model training, our method achieved a sensitivity of 97.8%, specificity of 97.9%, and accuracy of 97.9% in five-fold cross-validation. Compared to the supervised learning method with complete labeled samples, the detection accuracy of our method was only 0.5% lower, while the workload of data annotation was significantly reduced by more than 98%. In general, this is the first study to apply semi-supervised learning techniques for automatic AF detection using ECG. Our method can effectively reduce the demand for AF data annotations and can improve the clinical practicability of automatic AF detection.

3D reconstruction of stereo endoscope image, as an enabling technique for varied surgical systems, e.g., medical droids, navigations, etc., suffers from severe overfitting problems due to scarce labels. Semi-supervised learning based on Teacher-Student Network (TSN) is a potential solution, which utilizes a supervised teacher model trained on available labeled data to teach a student model on all images via assigning them pseudo labels. However, TSN often faces a dilemma: if given only few labeled endoscope images, the teacher model will be trained to be defective and induce high-noised pseudo labels, degrading the student model significantly. To solve this, we propose an improved TSN for a robust 3D reconstruction of stereo endoscope image. Specifically, two novel modules are introduced: 1) a semi-supervised teacher model based on adversarial learning to produce mostly correct pseudo labels by forcing a consistency in predictions for both labeled and unlabeled data, and 2) a confidence network to further filter out noisy pseudo labels by estimating a confidence for each prediction of the teacher model. By doing so, the student model is able to distill knowledge from more accurate and noiseless pseudo labels, thus achieving improved performance. Experimental results on two public datasets show that our improved TSN achieves a superior performance than the state-of-the-arts by reducing the averaged disparity error by at least 13.5%.