Electrical signals trigger the heart to contract, regulating the heartbeat. Any problems with these signals create heart rhythm disorders, which are experienced by millions of people and can lead to sudden death. Until now, detailed mapping of the heart’s electrical activity has been rare – requiring either a catheter to be inserted inside the heart cavity or performed using single-use devices that were expensive and laborious to set up, and involved radiation. Now, a reusable vest that can map the heart’s electrical activity in fine detail could be used to better identify individuals at a high risk of sudden cardiac death.

Researchers at University College London (UCL, London, UK) have developed an electrocardiographic imaging (ECGI) vest, offering a reusable, efficient solution for mapping the heart's electrical activity. This vest, requiring only five minutes per patient, stands out as it employs dry electrodes that are washable between uses, unlike traditional metallic electrodes that need a gel layer for skin contact. This marks the first instance of such electrodes being used in ECGI technology. The vest features 256 sensors, whose electrical data, when merged with detailed heart structure images from MRI (magnetic resonance imaging), create 3D digital models illustrating the heart's electrical activity waves.

The vest's practicality was validated in a study involving 77 patients, proving its reliability and durability. Since its inception, it has been successfully applied to 800 patients, a significant increase from previous studies that mapped heart electrical activity, which typically involved 20 to 30 patients. This advanced stratification method aids clinicians in identifying candidates for an implantable cardioverter defibrillator (ICD), a device that can be crucial yet carries risks like infection and distress from unnecessary shocks. The vest’s potential biomarkers for risk prediction will undergo further examination in longitudinal studies, tracking patients over time to assess the association of these markers with higher risk outcomes. Currently, the ECGI vest is being employed to map the hearts of individuals suffering from conditions like hypertrophic cardiomyopathy and dilated cardiomyopathy. The vest has already been patented in the U.S., and the research team is exploring options for broader manufacturing.

“We believe the vest we have developed could be a quick and cost-effective screening tool and that the rich electrical information it provides could help us better identify people’s risk of life-threatening heart rhythms in the future,” said Dr. Gaby Captur from the UCL Institute of Cardiovascular Science and the Royal Free Hospital, who developed the vest. “In addition, it can be used to assess the impact of drugs, new cardiac devices, and lifestyle interventions on heart health.”

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