Cardiologent: Multi-Agent Clinical Decision Support for Patient-Level Arrhythmia Assessment, Urgency, and Management
This study addresses the limitation of existing arrhythmia analysis methods, which typically identify only rhythm types without providing personalized clinical decision support. The authors propose the first end-to-end multi-agent system that integrates single-lead electrocardiogram and photoplethysmography signals to construct patient-level rhythm profiles. By incorporating clinical data and retrieval-augmented guideline reasoning, the system generates auditable diagnostic and therapeutic recommendations. It uniquely unifies rhythm assessment, clinical significance interpretation, and urgency-based management advice within a collaborative multi-agent framework, further validated through expert alignment mechanisms. The approach achieves state-of-the-art performance across tasks including comprehensive diagnosis, clinical relevance determination, urgency stratification, and management suggestion, with inter-rater agreement (ICC = 0.74 with cardiologists and 0.66 with large language models) comparable to inter-expert consensus (ICC = 0.67).