GeoRVQ: Decoder-aware geometry for residual-token prediction in physiological signals

Abstract

Residual vector quantization (RVQ) turns physiological waveforms into compact token sequences, but conventional masked modeling treats every incorrect token as equally costly. We propose GeoRVQ, a coarse-to-fine masked token model whose objective reflects the local response of a frozen waveform decoder. Decoder-induced costs define geometry-aware soft targets and expected distortion, while quantizer-causal prediction follows residual dependencies from coarse to fine levels. In a descriptive aggregate over MIMIC-IV Waveform, VitalDB, and CODE-15\%, GeoRVQ increases exact token accuracy from $.133\pm .004$ to $.143\pm .003$, reduces decoded distance from $.606\pm .006$ to $.393\pm .007$, and increases R-peak F1 from $.784\pm .004$ to $.837\pm .008$ under matched model and training conditions. Across 45 held-out code substitutions, decoder-induced cost has a Spearman correlation of $.85$ with realized decoded cost, compared with $.54$ for Euclidean codeword distance. These results indicate that decoder-aware objectives can improve waveform and event preservation without requiring a large increase in exact token accuracy.