ECGI vest could identify patients at risk of sudden cardiac death

Researchers have developed an electrocardiographic imaging (ECGI) vest which can map the electrical activity of the heart and identify people at high risk of sudden cardiac death.

The researchers, writing in the Journal of Cardiovascular Magnetic Resonance, say the technology holds the potential to be used in standard care, providing an alternative to costly, time consuming and invasive devices such as catheters.

Dr Gaby Captur of University College London, who developed the vest, says it is a “quick and cost-effective screening tool”, since it is reusable and takes only five minutes per patient.

As well as identifying people at risk of life-threatening heart rhythms, Dr Captur says the ECGI vest could also be used to assess the impact of drugs, new cardiac devices and lifestyle interventions on heart health.

Vest could be used as a time saving alternative to standard practice

Two million people in the UK have heart rhythm disorders, yet Dr Captur says the standard technology to monitor the heart’s electrical activity, the 12-lead electrocardiogram (ECG), has barely changed in 50 years.

With this technology alone, it is difficult to predict the sudden risk of cardiac death and how risk may be affected by a particular structural feature or abnormality of the heart.

The researchers now hope ECGI vests could obtain potential biomarkers that could be used to predict the risk of sudden cardiac death, adding a ‘missing part of the puzzle’.

Dr Matthew Webber (UCL Institute of Cardiovascular Science), vest co-developer, said: “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.”

Longitudinal studies now needed to test ECGI vest

The ECGI vest has 256 sensors which provide electrical data on the heart’s rhythm. This can be combined with detailed images of the heart’s structure taken by MRI to generate 3D digital models of the heart and the waves of electrical activity flowing through it.

A study evaluating the vest’s efficacy in 77 patients found it to be reliable and durable. Since then, the vest has been successfully used in around 800 patients.

Now, it is being used to map the hearts of people with diseases such as hypertrophic cardiomyopathy and dilated cardiomyopathy.

The vest now needs to be tested in longitudinal studies that follow people over time to see if potential biomarkers obtained via the ECGI vest are associated with higher risk outcomes.