Science
Reusable vest can detect earlier signs of heart muscle disease
A reusable vest that can map the electric impulses of the heart in fine detail could detect abnormalities from a potentially fatal heart disease much earlier than is currently possible, according to a new study we’ve part-funded published in the Journal of the American College of Cardiology.
The study found that an electrocardiographic imaging (ECGI) vest, developed by a team at University College London (UCL), could detect electrical changes associated with the inherited heart muscle condition hypertrophic cardiomyopathy. The vest was able to spot signs of the condition earlier than current tests can.
The inherited genetic changes that cause hypertrophic cardiomyopathy result in the muscle wall of the heart becoming thicker and stiffer, affecting how well the heart can pump blood around the body. It’s estimated to affect around one in 500 people in the UK.
Screening for sudden death
While often people with genetic variants that cause the disease have no symptoms at all, the condition can lead to heart failure and is frequently cited as the most common cause of sudden unexpected death in young people.
The ECGI vest has 256 sensors rather than the 12 used in a standard electrocardiogram (ECG) and can provide detailed electrical mapping of the heart in just five minutes.
Previously, this kind of detailed mapping was rare – either requiring a catheter to be inserted into the heart or using single-use devices that were costly and time consuming to set up. The ECGI vest is also reusable and so has potential to be used as a standard screening tool.
Dr Sonya Babu-Narayan, our Associate Medical Director and a consultant cardiologist, said: “The ECG has been at the heart of a doctor’s diagnostic toolkit for more than 100 years, allowing a window for us to understand the electrical pulses that control the beat of the heart.
“While further research is needed, this study suggests that the ECGI vest, which collects far more detailed electrical signal data than a routine ECG, could support better identification of high risk patients with hypertrophic cardiomyopathy.
“Some people living with hypertrophic cardiomyopathy are particularly susceptible to cardiac arrest. The ECG vest could offer an opportunity for doctors to better diagnose them early in their disease course and target their treatment to prevent this.”
The new study looked at 174 patients who had previously had genetic testing for HCM, recruited from three London hospitals, and 37 healthy volunteers. Patients included people who already had hypertrophic cardiomyopathy as well as individuals with disease-causing genetic mutations who did not have clear signs of the disease.
"Potential to stop the disease entirely"
The team found that the ECGI vest identified electrical abnormalities among a quarter of individuals with a gene mutation for whom no signs of disease were detected via current standard testing.
Lead author Dr George Joy, BHF Clinical Research Training Fellow at UCL, said: “By finding subtle electrical abnormalities using our new technique, we are able to detect hypertrophic cardiomyopathy earlier. This is important as it means we can potentially act earlier, providing new treatment to slow the disease as well as fast-tracking individuals to clinical trials that have potential to stop the disease entirely.”
“Next steps of the research include repeating these results in a larger group of patients and following individuals over time to see how these early electrical changes affect the risk of life-threatening heart rhythms later on.”
The study was also supported by the National Institutes of Health and Care Research (NIHR), Medical Research Council, and NIHR Biomedical Research Centres at UCLH and Barts Health NHS Trust.