Scientists have developed a groundbreaking approach to treating serious heart rhythm disorders by creating digital replicas of the heart, known as digital heart twins.
These computerized models can pinpoint problem areas deep in the heart muscle, potentially transforming how doctors diagnose and treat life-threatening conditions caused by heart attacks or inherited disorders.
The study, published in Circulation, shows that digital heart twins can identify scarred regions of the heart that cause abnormal rhythms, offering a non-invasive alternative to traditional methods.
According to Dr. Michael Waight, a cardiologist at St. George’s University of London and lead author of the study, this innovation could lead to safer and faster treatments for a growing number of patients.
“More people are living with the long-term effects of heart attacks, increasing the need for procedures to treat dangerous rhythms,” he said.
Scar-dependent ventricular tachycardia (VT) is one such condition. It is a rapid and irregular heart rhythm caused by scar tissue on the heart muscle, either from a past heart attack or a genetic condition.
Treatments for VT include implanting a defibrillator to restore normal rhythms or using a catheter to burn the scar tissue. However, these methods have limitations. Defibrillators cannot prevent future abnormal rhythms and may cause discomfort with repeated shocks.
Ablation procedures, which aim to destroy scarred tissue, can be difficult and risky because scarring often occurs deep within the heart or in multiple locations.
To perform ablation, doctors traditionally insert a catheter to map the heart’s electrical activity and locate problem areas.
This process can be time-consuming, invasive, and sometimes imprecise, as it involves inducing abnormal rhythms during the procedure. Patients with severe heart conditions face additional risks during these lengthy treatments.
The digital heart twin offers a potential solution. Using advanced imaging and patient data, researchers created 3D computer models of the hearts of 18 patients with scar-dependent VT.
These models simulated the heart’s structure and electrical activity, predicting areas where dangerous rhythms were likely to occur. The predictions were then compared to actual maps of the patients’ hearts created during traditional procedures.
The results were promising. Digital heart twins identified problem areas with 41% more accuracy than unflagged regions. They also correctly predicted 80% of the sites where electrical signals slowed down, which is a key indicator of scarring.
Dr. Waight explained that this technology allows doctors to target problem areas more precisely, even before the patient undergoes a procedure. “We can already know where to focus treatment, saving hours of mapping during surgery,” he said.
In addition to improving precision, digital heart twins could reduce the recurrence of abnormal rhythms and the need for repeat procedures. They can simulate not only current rhythm problems but also predict future issues, offering a comprehensive treatment plan.
While the study has not yet tested using digital twins to guide actual ablation procedures, the findings lay the groundwork for clinical trials. “The next step is to compare the current standard of care with a strategy guided by digital twins from the outset,” Dr. Waight noted.
Experts in the field, including Dr. Dhanunjaya Lakkireddy from the Kansas City Heart Rhythm Institute, see this technology as a major advancement. “It’s like having a road map that shows exactly where to focus treatment,” he said.
By eliminating unnecessary ablations, digital twins could make procedures faster and more effective, potentially improving survival rates and patient outcomes.
However, challenges remain. Creating a digital heart twin requires sophisticated and costly technology, which could limit widespread access. “Whether we can apply this on a large scale is still an open question,” Dr. Lakkireddy said.
Despite these hurdles, digital heart twins represent a significant step forward in cardiac care. By providing a detailed view of the heart’s problem areas, this technology has the potential to improve treatment outcomes and quality of life for patients with dangerous heart rhythms.
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The research findings can be found in Circulation.
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