Multimodal PPG-Based Arrhythmia Detection Using a CLIP-Initialized Multi-Task U-Net and LLM-Assisted Reporting.

Photoplethysmography (PPG) has emerged as an attractive modality for non-invasive cardiovascular monitoring due to its low cost, unobtrusive nature, and ubiquity in consumer wearable devices. Despite its potential, existing PPG-based arrhythmia detection systems remain limited in scope: (i) most target only atrial fibrillation, (ii) temporal localization of abnormal segments is rarely provided, and (iii) deep learning models lack explainability, hindering adoption in clinical workflows. We present a comprehensive and fully integrated framework for multi-class arrhythmia detection, segmentation, and explainability based on PPG waveforms, Heart Rate Variability (HRV), and structured clinical metadata. The proposed system introduces a CLIP-style contrastive learning module aligning PPG waveforms with clinical variables and rhythm-state textual descriptions using BioBERT; a multitask U-Net architecture performing 4-class classification and 1D segmentation; a Retrieval-Augmented Generation (RAG) pipeline leveraging Gemini Flash large language models to produce guideline-grounded diagnostic reports; and a real-time Streamlit-based web platform supporting inference, visualization, and database storage. The system significantly improves classification accuracy (from 86.27% to 91.19%) and segmentation Dice (from 0.5815 to 0.7167). These results demonstrate the feasibility of a robust, multimodal, and explainable PPG-based arrhythmia monitoring system for real-world applications.