A recent study reveals that the creation of a digital replica of the heart, referred to as a digital heart twin, may prove effective in identifying problematic areas deep within the heart muscle of individuals suffering from a severe heart rhythm disorder. This research could pave the way for innovative therapies aimed at addressing a life-threatening condition frequently linked to previous heart attacks or inherent heart disorders.
The findings, recently published in the American Heart Association’s journal, Circulation, indicate that digital heart twins could serve as a non-invasive tool to pinpoint scarred regions of the heart muscle that contribute to abnormal rhythms. This advancement enables cardiologists to provide more prompt and efficient treatments. Dr. Michael Waight, the study’s primary author and a cardiology registrar at St George’s University of London, highlighted that as more individuals survive the consequences of heart attacks, the demand for procedures to manage serious abnormal heart rhythms is rising. He pointed out that the integration of digital twins into medical practice could lead to safer and potentially more effective treatments.
Scar-dependent ventricular tachycardia, or VT, is a hazardous and sporadic rapid heart rhythm that arises from scar tissue on the heart muscle, a condition often resulting from prior heart attacks or genetic predispositions. Current treatment methods include the implantation of defibrillators to restore a normal heartbeat or catheter insertion for ablating, or burning away, the problematic scar tissue responsible for abnormal rhythms. Dr. Waight noted that both procedures come with limitations, such as the fact that defibrillators do not prevent the recurrence of abnormal rhythms. Repeated shocks can lead to discomfort for patients and a decline in their quality of life.
The search for scarred areas within the heart requires surgeons to create a detailed map of the patient’s interior by utilizing a catheter to detect electrical pulses that signify problematic zones. Surgeons may also provoke abnormal rhythms to accurately locate the source of these disturbances. Once identified, they burn away specific sections of scar tissue, but challenges persist, such as navigating multiple scar locations, which can increase complications and recurrence rates.
Dr. Waight and his fellow researchers explored whether these digital heart twins could predict the locations where abnormal rhythms might arise. They developed computer models based on advanced cardiac imaging and data from 18 individuals experiencing scar-dependent VT who were slated for catheter ablation procedures. By employing a catheter to prompt the abnormal rhythm, they mapped each participant’s heart, identifying areas of concern.
During their investigations, they tested the digital models against the rhythm issues experienced by participants in reality. The results indicated that the regions identified by digital twins exhibited a 41% higher frequency of abnormalities compared to unflagged areas, suggesting that these digital models could effectively highlight potential treatment zones without the time-consuming process of catheter mapping. Additionally, the digital twins identified approximately 80% of sites in the patients’ hearts where electrical signal slowdowns were observed, which typically occur near scarring within the heart muscle.
“Digital twins can render the heart in a three-dimensional format, pinpointing the location of faulty electrical circuits,” Dr. Waight explained. This advancement allows medical professionals to target specific areas even before the patient arrives for catheter procedures, thereby streamlining the treatment process and reducing the time spent on mapping.
Furthermore, the adoption of digital heart twins could minimize the recurrence rate of abnormal rhythms and the subsequent need for further treatment. Dr. Waight emphasized that these digital models not only predict existing VTs but also forecast potential future occurrences. However, researchers have not yet evaluated the effectiveness of these digital heart twins in guiding catheter ablation procedures. The next step involves clinical trials comparing current VT ablation standards with a strategy guided by digital twins from the onset.
These promising results suggest a significant reduction in treatment time for VTs, enhancing both safety and effectiveness, according to Dr. Dhanunjaya Lakkireddy, executive medical director at the Kansas City Heart Rhythm Institute. He mentioned that effectively targeting areas prone to ventricular tachycardia could shorten procedure duration by allowing more precise interventions with minimal unnecessary ablation. This approach has the potential to improve patient outcomes significantly by increasing the success rate of procedures while lowering morbidity and mortality rates.
Dr. Lakkireddy, though not involved in the study, remarked that the digital heart twin offers a focused roadmap for treatment, marking a significant advancement in the field. However, he cautioned that the technology required for such procedures is advanced and could pose accessibility challenges due to cost implications. He stated, “Whether we can implement this on a larger scale remains uncertain, since creating a digital twin currently comes with significant expenses.”
