Medical informatics scientists of the King’s College London have developed a new way to detect early warning signs of sudden cardiac arrest, analyzing the shape of a person’s heart with machine learning methods.
The results of the Research have been published in the scientific journal EP Europace.
Heart shape and signs of a heart attack: this is what the research says
The research was tested by analyzing MRI images of 156 patients with dilated cardiomyopathy, a fatal disease of the heart muscle.. Patients who have subsequently suffered sudden cardiac arrest may be detected by subtle changes in the shape of the heart, believed to be signs of worsening of the disease.
Doctor Pablo Lamata, professor at the King’s College London School of Biomedical Engineering & Imaging Sciences, who led the research, said the new method of heart shape analysis has implications for the use of defibrillator implant therapies.
“There are lost people who die of sudden cardiac arrest because they didn’t know they needed it. Clearly by better identifying patients who need defibrillators we can save more lives, save money and prevent unnecessary treatments.“, Says Dr. Pablo Lamata, senior researcher.
The data show that only 50 percent of sudden cardiac arrest cases involve previous symptoms. Many of these patients’ lives could be saved with implantable defibrillators if only doctors knew they are at risk.
“Given to the right patients, implantable defibrillators prevent cardiac arrest by automatically returning the heart to a normal rhythm. However, finding out which patients actually need an implantable defibrillator is a difficult challenge“Said Dr. Gabriel Balaban, postdoctoral researcher.
The use of defibrillator implants is controversial. Previous medical studies have shown that for every defibrillator implant that saves a life, there are 10 to 40 unnecessary ones. As approximately 85,000 defibrillators are implanted in Europe each year, this represents a major problem, both in terms of cost and patient complications.
Each defibrillator implant costs approximately € 46,000 over the patient’s lifetime and carries the risk of very powerful superfluous discharges.
“With further testing and more patient data, we hope to develop our heart shape analysis method into a practical tool for cardiologists to select the right patients for treatment with implantable defibrillators.”, said Dr. Lamata.
An online service is being released that provides access to the new heart shape analysis method. Cardiologists and other researchers only need to upload the borders of the heart, which is anonymous and safe to share.
In return, the service provides a 3D shape model and Sudden Cardiac Arrest Risk Score, so that new risk prediction techniques can be further tested by other groups. The researchers say the new heart shape analysis could also be used for other diseases because the heart changes shape for other reasons as well, such as hypertension or hypertension.
Cardiovascular disease is a leading cause of global mortality, causing nearly 17 million deaths annually or 30% of all global mortality. In developing countries it causes twice as many deaths as HIV, malaria and tuberculosis combined.
It is estimated that about 40-50% of all cardiovascular deaths are sudden cardiac deaths (SCD) and about 80% of these are caused by ventricular tachyarrhythmias. Thus, approximately 6 million sudden cardiac deaths occur each year due to ventricular tachyarrhythmias. The survival rate for sudden cardiac arrest is less than 1% worldwide and close to 5% in the United States.
Prevention of cardiovascular disease by raising awareness of risk factors such as lack of exercise, inappropriate diet, and smoking has reduced cardiovascular mortality in the United States over the past few decades. However, there is still a huge burden of cardiovascular disease globally and in the United States. Therefore, it is necessary to develop complementary strategies for the management of sudden cardiac death.
Data from several studies conclusively indicate that implantable defibrillators improve mortality in patients who have had an episode or are at high risk of developing ventricular tachyarrhythmias. These devices are reimbursed and are used frequently in developed economies for managing MCI.However, due to the low level of public and private health expenditure in developing economies and the relatively high cost of ICDs, implantation rates are very bass.
Automated external defibrillators and AED-equipped emergency medical response services provide complementary and alternative opportunities for managing MCI. There are several challenges associated with adopting these strategies. The effectiveness and cost-effectiveness of these strategies must be compared with ICDs to determine the appropriate strategy for various geographic areas. The presentation will discuss the global problem of SCD and the various options for its management.
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