A simple method for electronically monitoring patient heart rhythm can improve the treatment of heart rhythm disorders and prevent strokes.
As a world first, the Danish company Cortrium and researchers at DTU have successfully developed a small and unique sensor which is placed on the skin above the heart and which can easily be used at home. The Holter monitor sends online measurements of the heart’s rhythm in several channels—and thus opens up for completely new possibilities for monitoring patients with heart rhythm disturbances, or heart arrhythmia.
Today, elderly patients with heart arrhythmia find that obtaining a diagnosis and being treated is often a tedious process requiring numerous trips to the doctor. Simply measuring your heart rhythm involves borrowing a Holter monitor which must be worn for at least 24 hours. This means that frail elderly people often give up on being examined by their own doctor, a cardiologist or at a laboratory.
“In future, your local doctor will be able to offer this small Holter monitor which measures the patient’s heart rhythm in real time. The measurements are also linked to analyses that enable the doctor to see whether the heart rate is normal or if there are any irregularities. This will accelerate diagnosis and subsequent medical treatment significantly, which could prevent many of the strokes which elderly patients suffer today,” explains Sadasvian Puthusserypady from DTU Electrical Engineering, who is heading the work of the technical researchers.
Algorithms enable rapid diagnosis
Together with Cortium and cardiologists at Bispebjerg Hospital, the research team at DTU are part of a major project—REAFEL—which is supported by Innovation Fund Denmark. The researchers have already shown that it is possible to prepare algorithms which can identify cardiac arrhythmia, so-called atrial fibrillation. The data used is freely available on the Internet.
This work now needs to be transferred to measurements of the heart rhythms of more than 150 Danish patients. The involved cardiologists will then analyse the data for diagnosing whether a person’s heart rhythm is normal, or whether there are disturbances which require medical treatment.“We receive the cardiologists’ analyses, and then we can teach our algorithms when a patient’s heart rhythm is normal or abnormal, and thus indicate a disturbance. We have prepared the first algorithms based on data from the Internet, but now they need to be adapted and refined using the diagnoses which the cardiologists are making available on the basis of measurements from the Danish patients,” says Sadasvian Puthusserypady.
“In this way, we can facilitate and make the work of diagnosing cases of serious heart arrhythmia more precise. In future, this can be automated without it involving several hours of analysis by a cardiologist—just as the algorithms won’t be influenced by subjective factors, unlike diagnosis today.”
Online monitoring
Cortrium’s new sensor also means that monitoring a patient can be done online and in real time—not like at present where it only happens for a limited period, while the data is not analysed until the measurements from the Holter monitor are sent to a cardiologist.
“In developing a new Holter monitor, we will be able to intervene and treat patients with atrial fibrillation far earlier than is possible today. And as heart arrhythmia is the biggest cause of strokes at the moment, we expect to see a significant fall in the number of cases once the project is over. In the Capital Region of Denmark alone, we anticipate that it will be possible to prevent up to 600 strokes a year,” says Helena Domínguez, a consultant cardiologist at the Department of Cardiology at Bispebjerg and Frederiksberg Hospital, who is responsible for the clinical part of the project.