ELF: A Family of Encoder-Free ECG-Language Models

Abstract

ECG-Language Models (ELMs) extend recent advances in Multimodal Large Language Models (MLLMs) to automated ECG interpretation. However, most existing ELMs inherit Vision-Language Model (VLM) design choices and rely on pretrained ECG encoders, introducing substantial architectural and training complexity. Inspired by encoder-free VLMs, we introduce ELF, a family of three encoder-free ELM architectures that remain competitive with, and often outperform, prior state-of-the-art ELMs across two datasets despite substantially simpler architectures and training pipelines. All code and data is available at github.com/ELM-Research/ECG-Language-Models.