LAEF: A Lead-Agnostic ECG Foundation Model Towards Point-of-Care Diagnostics

Point-of-care cardiac devices such as smartwatches and handheld ECG recorders typically capture 1--2 leads, yet existing ECG foundation models are architecturally constrained to fixed 12-lead inputs, degrading or failing under these reduced configurations. We introduce LAEF (Lead-Agnostic ECG Foundation), a 7M-parameter ECG foundation model that can natively process any lead subset without zero-padding or architectural modification. LAEF represents ECGs as variable-size spatiotemporal graphs with physiologically motivated intra- and inter-lead connectivity, processed by a Graph Attention Network that scales naturally with active lead count.Pre-trained on 9.2M 12-lead ECGs via masked node modelling with stochastic lead sampling, LAEF learns representations robust to lead configuration. Across 18 downstream datasets, LAEF is on par with specialized 12-lead baselines over 12$\times$ larger at full lead availability. Under direct point-of-care-oriented diagnostics (1--2 leads), it outperforms all zero-padded alternatives on 17 out of 18 datasets with with a single randomly sampled lead and on 14 out of 18 with 2 leads, with an average AUROC gain of +3.2 points. Representation analysis links this advantage to architectural lead-agnosticism, and a lead-importance study across 164 cardiovascular conditions shows population-level performance is stable across single standard input leads while still recovering established clinically lead-condition associations.

Benchmarking Sheaf Neural Networks for Inductive Tasks

Sheaf Neural Networks (SNNs) generalize message passing by replacing scalar edge weights of standard Graph Neural Networks (GNNs) with learnable, edge-dependent restriction maps between node stalks. Despite their strong theoretical foundations and promising transductive results, SNNs have been evaluated almost exclusively on transductive node classification, leaving their behaviour under inductive protocols unknown. We address this gap through the first systematic benchmark of the sheaf design space, evaluating three diffusion mechanisms (neural sheaf diffusion, sheaf attention, and sheaf attention with Graph Attention Network v2), three restriction-map parameterizations, three stalk dimensions, and six modern GNN architectural components, within a message-passing reformulation that never assembles the heavy sheaf Laplacian, making the full design space trainable under cross-graph batching. Across $1{,}890$ controlled experiments on 14 inductive datasets, multiple insights emerge: restriction maps are the dominant design choice and general maps are preferable, larger stalks add capacity but not long-range reach, architectural components explain more performance variation than the entire sheaf-specific design space itself. Under a matched protocol, SNNs transfer to inductive settings but do not reach the strongest baselines, with gaps being dataset-dependent. Practically, a single sheaf configuration can generalize across datasets, so effort is better spent tuning the surrounding architectural recipe than the sheaf operator itself.