Capturing Cardiac Cyclicity through Phase-Equivariant Self-Supervised Learning

The cyclic structure of physiological processes offers a natural prior for self-supervised representation learning, and the cardiac cycle provides a particularly well-defined setting in which to exploit it. We derive a phase-equivariant self-supervised objective and introduce Winder, a joint-embedding architecture that organises representations into phase-invariant coordinates and phase-rotating harmonic subspaces. Its transport operator is fixed and closed-form, derived from the cycle's geometry rather than learned, and adds no parameters. Evaluated on PTB-XL under a frozen linear-probe protocol, Winder attains diagnostic accuracy within the range reported by state-of-the-art self-supervised methods at a ~1 M parameter footprint, while exhibiting phase-equivariant latent geometry. These findings demonstrate that explicitly encoding cardiac-phase symmetry can preserve diagnostically useful information while yielding a latent geometry that is legible, parameter-efficient, and directly tied to a measurable physiological quantity.

CardioState-JEPA: Delay-Aware Cross-Modal Learning of a Shared Cardiac Representation

Electrocardiography (ECG), photoplethysmography (PPG), and phonocardiography (PCG) provide complementary views of the same cardiac cycle, yet existing cardiac foundation models are trained for a single sensing modality, leaving the shared physiology across sensors unexploited. We introduce CardioState-JEPA, a cardiac foundation model to learn a single shared representation jointly across ECG, PPG, and PCG, built on a physiology-aware joint-embedding predictive architecture. The model maps heterogeneous waveforms into a common token space, processes them with a single shared Transformer encoder, and learns by predicting masked latent cardiac states, placing the pretraining target on shared physiology rather than sensor-specific waveform appearance. To handle the temporal offsets between electrical, mechanical, and hemodynamic events, cross-modal prediction uses a learned delay aligner that matches signals at the corresponding cardiac time. Because synchronized multi-sensor recordings are scarce, CardioState-JEPA first learns within-modality structure from abundant unimodal data and then uses paired data to align modalities in latent cardiac time. Evaluated as a frozen encoder across 25 downstream tasks spanning ECG, PPG, and PCG, our encoder improves average PPG classification by 8.2 AUROC points, PCG murmur detection by 18.8 AUROC points, and ECG classification by 15.5 AUROC points over the best self-supervised signal baseline and matches or exceeds cardiac models trained with privileged clinical text or supervised labels on several ECG benchmarks. These results establish that heterogeneous cardiac signals can mutually supervise a single foundation model of cardiac physiology.