Researchers at University College London (UCL) have developed an electrocardiogram imaging (ECGI) vest that has the potential to be used in standard care because it is reusable and time-saving, requiring only 5 minutes per patient.
A new study led by researchers at University College London has shown that the reusable vest can map the heart's electrical impulses in detail, detecting abnormalities in underlying heart disease much earlier than is currently the case.
Hypertrophic cardiomyopathy is a disease that affects the heart in which the muscle walls thicken and stiffen, reducing its ability to pump blood effectively throughout the body. Although it is estimated that one in every 300 adults is affected by the disease, some people with the genetic variants that cause the disease do not experience any symptoms.
However, hypertrophic cardiomyopathy can lead to heart failure, and it is often cited as the most common cause of sudden death in young adults.
Lead author Dr Joy (UCL Institute of Cardiovascular Sciences and Butz Heart Centre) said: "By using our new technology to detect subtle electrical abnormalities, we were able to detect hypertrophic cardiomyopathy earlier. This is important because it means we can act earlier, offer new** ways to slow the disease, and fast-track clinical trials that have the potential to stop the disease altogether. ”
The next step in the study involves repeating these results in a larger patient population and following individuals over time to see how these early electrical changes affect life-threatening heart rhythm risk later in life.
The ECGI vest has 256 sensors that can provide a detailed electrical map of the heart in five minutes. This type of mapping was previously rare and required invasive surgery or expensive disposable equipment.
The ECGI vest is reusable and has the potential to become a standard screening tool.
The researchers tested the vest technique on 174 genetic test patients recruited from three hospitals in London and 37 healthy volunteers. Patients include people who already have hypertrophic cardiomyopathy, as well as people with disease-causing gene mutations who have no obvious signs of disease.
The research team found that even though standard cardiac imaging and electrocardiogram tests did not show any signs of disease, the ECGI vest could detect electrical abnormalities in 25% of individuals with genetic mutations. When ECGI vests were used, it was found that these patients exhibited an uneven pattern of electrical signal recovery and slowed the conduction of electrical signals through the heart.
In addition, the researchers developed a machine learning model to assess the severity of the disease and the risk of sudden cardiac death based on the results of 12 markers of the ECGI vest. They found that this grading system matched the risk estimated using a standard protocol that took into account factors such as age and certain structural features of the heart.
Dr. Reynolds, senior author of the latest study, said in a statement: "The ECGI vest we have developed is expanding our ability to understand the electrical function of the heart and more accurately assess people's risk of developing life-threatening heart rhythms. People with genetic mutations that cause hypertrophic cardiomyopathy are monitored regularly and recommendations are given about exercise. In some cases, this may be to reduce or stop any strenuous exercise. This prescription can have a huge impact on a person's quality of life, especially for athletes or young patients. By better understanding the risks, we hope to avoid people taking this advice unnecessarily. ”
Dr Narayan, Deputy Medical Director of the British Heart Society, added: "While further research is needed, this study suggests that ECGI vests can collect more detailed electrical signal data than conventional ECGs and can better identify high-risk patients with hypertrophic cardiomyopathy. Some people with hypertrophic cardiomyopathy are particularly susceptible to cardiac arrest. ECGI vests can provide an opportunity for doctors to better diagnose them early in the course of the disease and target them to prevent the condition. ”