Research
Smart T-shirt could reveal heart conditions in danger of being missed
A smart T-shirt with the power of AI could in future detect heart conditions as people go about their daily lives, thanks to research awarded more than £340,000 by us, at Imperial College London.
Currently people with symptoms like chest pains and dizziness take home a portable ECG, with precisely positioned sticky electrodes, connected with leads to a waist-worn monitor, which needs to be carefully removed and reattached whenever they have a shower.
Researchers say the T-shirt, which will have up to 50 sensors stitched into the fabric to mirror an ECG, could be far simpler to use.
It is designed to detect rare, inherited heart conditions, as it can also be worn for up to a week, giving it longer to pick up issues, compared to portable ECGs, which are typically used for 24 to 48 hours.
Dangerous heart rhythm disorder
The T-shirt is being developed with the help of Carly Benge, a 38-year-old teacher from Watford. Carly has Brugada syndrome, which is a dangerous heart rhythm disorder that researchers are hoping the T-shirt can detect.
Because the condition runs in families, her two children, seven-year-old Imogen and Jake, aged 10 are also at risk. Children like Imogen and Jake could access earlier treatment if they were identified early using the smart T-shirt.
Sudden cardiac death
Early diagnosis is vital for conditions like Brugada syndrome because, if they’re not spotted and treated, they can increase someone’s risk of sudden cardiac death.
Carly was only diagnosed with Brugada syndrome after her sister, Jodie, was found to have the same condition in 2018.
Jodie, who had experienced dizziness and heart palpitations while pregnant, was awaiting an ECG scan result, but discharged herself from hospital, assuming a delay in receiving her test results meant she was unlikely to be seriously unwell. She also desperately did not want to let down her mum, June, by missing her 60th birthday celebrations.
Carly said: “We were celebrating at Center Parcs when we got the call to say doctors were concerned about Jodie’s ECG readings and she may have Brugada Syndrome. We knew nothing about this condition, and had no idea that actually, this could be something quite serious. It was a very emotional and upsetting time.”
Jodie couldn’t be diagnosed at the time because she was pregnant with her first child, but four months after giving birth, doctors confirmed she had Brugada syndrome.
"A very emotional time”
‘Carly said: “Jodie had only just become a mum, and she suddenly needed surgery to have a defibrillator put inside her chest. I was really scared. It was really scary, and a very emotional time”.
As Brugada syndrome is often caused by a faulty gene inherited through families, Jodie’s diagnosis meant the rest of her family also needed to be tested. Carly, who had experienced no symptoms at all, was confirmed to have the condition also.
She said: ”Mum just burst into tears when she found out both of her daughters had this life-threatening condition. She isn’t a crier, so it really hit me hard hearing her so upset.
“I was reassured when they told me I was at low risk of a serious medical episode, but now my concern is more for my children, and Jodie's children, because there's a chance of them having it too.”
Around 340,000 people in the UK have an inherited heart condition which could put them at risk of dying from a dangerous heart rhythm. These inherited conditions can increase someone’s risk of sudden cardiac death if not spotted and treated. They are estimated to claim the lives of 12 young people under 35 in the UK each week.
Inherited heart conditions can also cause symptoms such as breathlessness or fainting during day-to-day activities like driving or exercising. However, diagnosing these conditions in hospital can be difficult, as heart rhythm tests and heart scans often appear completely normal.
The smart T-shirt project, led by Zachary Whinnett, Professor of Cardiology at Imperial College London, could provide a new method of diagnosis. Researchers will train the AI using data from more than 1,000 people – some with inherited heart rhythm conditions and others without – to teach the algorithm to recognise abnormal ECG patterns.
A smart T-shirt will be given to 200 patients and volunteers attending Hammersmith Hospital’s Peart-Rose Research Unit - a state-of-the-art cardiovascular research unit in London which is part of Imperial College Healthcare NHS Trust. The study participants will wear the T-shirt continuously for up to three months, to measure how well it picks up serious heart conditions.
The T-shirt will be designed using comfortable sportswear-style material which can be worn underneath clothes during daily activities, like sleeping, eating and working. It will have wires within the fabric to measure electrical signals, allowing patients to be monitored for longer periods of time.
"Reassured that our children are safe.”
Carly said: “You can wear this T-shirt for weeks and even put it through the wash, and then put it back on again, so it's a lot more practical than a portable ECG.
“I got involved in this research because I want my children to have more of a chance to be diagnosed early, if they do have Brugada syndrome. If we can catch Brugada sooner and prevent sudden death, it could make me, and other parents, feel far more reassured that our children are safe.”
The researchers hope the technology will be available for doctors to use in roughly five years. While the T-shirt will initially be developed and trialled on adults, if found to be effective, it could provide a new way to make heart monitoring more comfortable for children in future. Researchers also hope to make it available to help identify people with other heart rhythm conditions, such as atrial fibrillation, more easily.
"AI-assisted t-shirt"
Professor Zachary Whinnett, Professor of Cardiology at Imperial College London, said: “Far too many people die from inherited heart conditions which could be treated if they were identified earlier. One of the challenges of diagnosis today is that irregular heart rhythms may not always occur during routine 10- minute hospital ECGs or even 48-hour ECG monitoring at home. We hope our AI-assisted t-shirt will provide a practical and comfortable solution, allowing us to carry out longer-term scanning that could improve diagnosis.
“By harnessing the power of AI, we hope our research can transform doctors’ abilities to spot these conditions and improve the lives of those who are unknowingly living with a genetic heart condition.”
"Identify patients at risk of sudden death"
Professor James Leiper, our Director of Research, said: “Too many people have been snatched away from their loved ones in an instant by inherited heart conditions. This innovative research will leverage the power of AI to help clinicians unmask these hidden conditions and identify patients at risk of sudden death.
“The British Heart Foundation is dedicated to funding groundbreaking research like Professor Whinnett's, to help diagnose, treat and prevent sudden cardiac death, but there is still more to do. We urgently need donations to help us fund more lifesaving research to stop families losing a loved one.”