FHGNet: A Feature-Centric Hierarchical Network with Graph Attention Layer for Supraventricular Tachycardia...

Automated electrocardiogram (ECG) classification plays a critical role in arrhythmia diagnosis. However, current deep learning-based methodologies frequently fail to account for physiological rhythms and clinical diagnostic reasoning, thereby compromising their reliability and interpretability. This study proposes a clinically inspired multi-lead oscillatory Transformer framework, named FHGNet, to enhance the precision and interoperability of classifying ventricular tachycardia (VT) and supraventricular tachycardia (SVT). The proposed architecture integrates R-peak detection for heartbeat segmentation and adaptive-length patch extraction with R-wave positional encoding to enhance temporal awareness. It employs a convolutional neural network (CNN) to capture intra-beat morphological features (QRS morphology), a Transformer with FANLayer to model inter-beat rhythmic patterns, and a graph attention network (GAT) to fuse multi-lead dependencies. Additionally, a two-stage classifier is designed to enhance the detection of rare arrhythmia classes. Experimental evaluations on the MIT-BIH Supraventricular Arrhythmia dataset demonstrate FHGNet achieves a macro F1-score of 91.35% outperforming baselines. Ablation studies reveal that removing GAT reduces F1 by 2.42% in multi-lead scenarios, while the two-stage design improves minority class recall by 5.82%. Attention visualization confirms the model focuses on clinically relevant features, such as ST-T segment energy ratios and inter-lead phase differences, aligning with established diagnostic criteria. Additionally, the interpretability of FHGNet is further enhanced by two aspects: 1) Explicit integration of physiological priors (e.g., RR interval variability, intra-beat positional information) in dynamic feature engineering, which enables the model to align with clinicians' rhythm analysis logic; 2) The two-stage classifier strictly follows the clinical diagnostic workflow (first screening abnormalities, then subclassifying), making the decision-making process traceable. This work provides an interpretable, clinically adaptive framework for high-accuracy ECG classification, potentially reducing reliance on invasive electrophysiological studies.