Advanced Multimodal Feature Fusion of ECG and PCG Signals for Precise Cardiovascular Disease Diagnosis Using a Fuzzy‐Based Approach

ABSTRACT

The phonocardiogram (PCG) and electrocardiogram (ECG) are widely used for early detection and prevention of cardiovascular diseases (CVDs) due to their noninvasive acquisition and accurate representation of heart function from different perspectives. However, it is still challenging to extract discriminative characteristics without losing essential information, and few studies have successfully integrated PCG and ECG for CVD screening. Therefore, this research introduces a novel multimodal fused feature‐based CVD classification framework that uniquely integrates advanced preprocessing, modality‐specific feature extraction, and optimized classification. Raw ECG and PCG signals are preprocessed using multispectral adaptive wavelet denoising (MAWD) for noise removal, a U‐Net‐based sequence‐to‐sequence fully convolutional network (U‐TSS) for precise segmentation, and a frequency transformation layer (FTL) for frequency domain conversion. Novelty lies in the tailored feature extraction strategy employing a parallel convolutional neural network (PCNN) for PCG and HCR‐Net for ECG, followed by a Multi‐scale Contextual Feature Fusion (MC2F) based feature fusion mechanism that preserves complementary information across modalities. Classification is performed using the proposed Deep Maxout Fuzzy EfficientNet (DMFE), enabling highly discriminative decision boundaries and robust generalization. Experimental results demonstrate that the proposed ECG–PCG fusion approach surpasses existing methods, achieving 99.18% accuracy, 99.09% sensitivity, and 99.03% specificity. These results highlight the method's strong potential for practical medical deployment, offering high performance, flexibility, and comprehensive characterization of cardiac health.