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Using cutting-edge technology, researchers have developed a digital replica of the human heart—a “digital heart twin”—which could revolutionize the treatment of life-threatening heart rhythm disorders, particularly those caused by previous heart attacks or genetic conditions. A new study, published in Circulation, demonstrates the potential of digital heart twins in identifying abnormal heart rhythms and offering faster, more accurate treatment solutions.
The research, led by Dr. Michael Waight, a cardiology registrar at St George’s University of London, highlights how these digital twins could serve as a non-invasive method for pinpointing scar tissue within the heart, a common culprit behind abnormal rhythms that can cause severe health complications. As the number of individuals living with the aftermath of heart attacks rises, so too does the need for more efficient methods of treating these dangerous arrhythmias.
“People are now living with the consequences of heart attacks for many years, so the number of people needing procedures to treat these life-threatening abnormal rhythms is increasing,” Dr. Waight explained. “If digital twins become a reality, they could offer a safer and potentially more effective treatment method.”
Scar-dependent ventricular tachycardia (VT), a rapid and irregular heart rhythm triggered by scar tissue from prior heart attacks or inherited heart conditions, is typically treated with implanted defibrillators or catheter ablation. However, these methods have their limitations. Defibrillators often fail to prevent recurring abnormal rhythms, while catheter ablation, which involves burning scar tissue, can be time-consuming and risky, especially if the scarring is deep within the heart.
Currently, surgeons rely on catheter-based mapping to locate these problem areas by detecting electrical pulses in the heart. They may also induce abnormal rhythms to pinpoint where to apply the ablation. However, this method is not always successful, leading to complications and high recurrence rates.
Dr. Waight and his team aimed to improve this process by exploring how digital heart twins could predict the locations of scar tissue before the procedure. Using advanced cardiac imaging, they created detailed computer models of the hearts of 18 patients with scar-dependent VT. These digital models, built from patient-specific data, mimicked the heart’s structure and function, allowing the researchers to predict areas where abnormal rhythms were likely to occur.
When they compared the digital twins’ predictions to actual heart mapping, they found that the areas flagged by the digital models showed a 41% higher frequency of abnormalities. Furthermore, the digital twins accurately identified around 80% of the sites where electrical signals were slowed due to scarring.
“The digital twin can render the heart in 3D and show exactly where the faulty circuit is,” said Dr. Waight. “This means we can know which areas to target before the patient even arrives for the procedure, eliminating hours spent mapping the heart.”
The ability to predict abnormal rhythms before they occur could lead to more precise and effective treatments, potentially reducing the need for repeated interventions and improving long-term outcomes.
While the study has not yet tested the effectiveness of using digital heart twins to guide catheter ablation, the results show promise. “The next step is a clinical trial where we compare the current standard of care to a strategy guided by the digital twin,” Dr. Waight said.
Dr. Dhanunjaya Lakkireddy, Executive Medical Director of the Kansas City Heart Rhythm Institute, praised the research, noting that using digital twins could reduce the time needed for procedures and focus treatment on critical areas. “This could improve patient outcomes and reduce the morbidity and mortality associated with VT,” Lakkireddy said.
Despite its potential, the use of digital heart twins requires sophisticated technology, which can be expensive. Whether this approach can be widely adopted remains to be seen, as the costs associated with creating these digital models could limit their accessibility in many healthcare settings.
Still, the digital heart twin marks a significant leap forward in the treatment of dangerous heart rhythms, offering hope for more effective and precise therapies that could improve the quality of life for patients with complex heart conditions.
For more information, refer to the full study: Michael C. Waight et al., Personalized Heart Digital Twins Detect Substrate Abnormalities in Scar-Dependent Ventricular Tachycardia, Circulation (2024). DOI: 10.1161/CIRCULATIONAHA.124.070526.
