Real-world datasets often exhibit severe class imbalance, degrading the performance of deep learning models, particularly on rare classes. While imbalance is well studied in binary and multiclass settings, it is substantially more challenging in multilabel problems due to complex label co-occurrence. In clinical applications such as ECG classification, this challenge is coupled with a second critical challenge: the need to prioritize high-risk conditions, regardless of their prevalence, to mitigate the high cost of false negatives. We introduce the Multilabel Class-Prioritized Probabilistic Sampler (ML-CLAPPS), a learnable sampler that optimizes a distribution over training instances to control the model's exposure to different classes. This approach addresses multilabel imbalance while enabling prioritization of significant conditions via a user-defined importance vector (IV). Empirical evaluation on a real-world multilabel ECG image dataset demonstrates that ML-CLAPPS achieves state-of-the-art performance. We show that it aligns class exposure with the specified IV, and that increasing a class's importance leads to corresponding improvements in its classification performance, enabling explicit prioritization of clinically critical conditions.

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