A Lightweight Multiscale Deep Learning Framework for Automated Cardiovascular Disease Classification from Standard 12-Lead ECG Images

Cardiovascular diseases (CVDs) are the leading cause of global mortality, highlighting the need for efficient and reliable automated electrocardiogram (ECG) analysis. While deep learning methods have achieved high classification accuracy, their large model sizes and computational demands limit clinical deployment. This study proposes a lightweight multiscale framework, the FPN–ECA–ELM, integrating a feature pyramid network (FPN), efficient channel attention (ECA), and an extreme learning machine (ELM) for automated CVD classification using standard 12-lead ECG images. The FPN enables efficient multiscale feature fusion by combining feature maps from different network depths to generate high-resolution semantically enriched representations. ECA performs channel-wise feature recalibration, and the ELM replaces conventional fully connected layers, further reducing computational cost. Under an inter-patient evaluation protocol, the model achieved 87.08% accuracy and 87.07% weighted F1-score for binary classification, and 78.06% accuracy and 78.34% weighted F1-score for five-class classification, demonstrating competitive classification performance. The model contains only 1.73 million parameters, with a size of 6.59 MB, requiring 0.21 GFLOPs, and achieves an inference time of 0.69 ms per sample. These results illustrate a favorable balance between accuracy and efficiency, supporting practical deployment in resource-constrained clinical and edge-computing environments.