A new study led by UCL researchers has suggested that a heart vest can be used to better identify people at high risk of sudden cardiac death.
A vest that has the ability to map the electrical activity of the heart could be used to identify people at high risk of sudden cardiac death, suggests a new study led by UCL researchers.
Electrical signals trigger our hearts to contract to regulate our heartbeat. Problems with these signals result in heart rhythm disorders which are experienced by two million people in the UK. They can cause sudden death.
Until now, mapping of the heart’s electrical activity was rare. This is because it required either a catheter to be inserted inside the heart cavity or expensive and time-consuming single-use devices that involve radiation.
An electrocardiographic imaging vest has been developed by UCL researchers that holds the potential to be used in standard care as it is re-usable and time-efficient.
The research is published in the Journal of Cardiovascular Magnetic Resonance.
Generating 3D heart models
Electrical data from the heart vest’s 256 sensors can be combined with detailed images of heart structures taken by MRI. From this combination, 3D models of the heart and the waves of electrical activity flowing through it could be generated.
Dr Gaby Captur, who developed the vest with funding from the British Heart Foundation and the Society for Cardiovascular Magnetic Resonance, said: “We identified a problem in cardiology. Heart imaging has made remarkable progress in recent decades, but the electrics of the heart have eluded us.
“The standard technology to monitor the heart’s electrical activity, the 12-lead electrocardiogram (ECG), has barely changed in 50 years.
“We believe the vest we have developed could be a quick and cost-effective screening tool and that the rich electrical information it provides could help us better identify people’s risk of life-threatening heart rhythms in the future.
“In addition, it can be used to assess the impact of drugs, new cardiac devices, and lifestyle interventions on heart health.
“Currently, predicting risk of sudden cardiac death is difficult, as it is not known, for instance, how risk might be affected by a particular structural feature or abnormality of the heart.”
Identifying people in need of an implantable cardioverter defibrillator
The researchers argue that better stratification of risk would help clinicians identify people in need of an implantable defibrillator. This device monitors heart rhythm and shocks the heart back into a normal rhythm if needed.
Although these devices are lifesaving, there is a risk of infection, and they can cause distress if shocks are given when unnecessary.
Predicting risk with the heart vest
It will need to be confirmed whether the heart vest can predict cardiac death risk via potential biomarkers. Longitudinal studies would follow people over time to see if the biomarkers obtained are associated with higher-risk outcomes.
Dr Matthew Webber, vest co-developer, added: “Cardiac MRI, the gold standard in heart imaging, shows us the health of the heart muscle tissue, including where dead muscle cells might be.
“In-depth electrocardiographic imaging can help us correlate these features with their consequences – the impact they may be having on the heart’s electrical system. It adds a missing part of the puzzle.”
Advantages of the heart vest
The team’s ECGI vest is reusable because it uses dry electrodes which can be washed in between uses. This is the first time such electrodes have been used for ECGI.
The researchers assessed the vest’s feasibility in 77 patients and found it to be reliable and durable.
Now, the vest has since been used successfully in 800 patients, mapping the hearts of people with diseases such as hypertrophic cardiomyopathy and dilated cardiomyopathy.
