A non-invasive and personalised 3D virtual heart assessment tool may help doctors prevent life-threatening arrhythmia by identifying patients at high risk of sudden cardiac arrest.

Currently doctors implant a small defibrillator to sense the onset of arrhythmia and jolt the heart back to a normal rhythm. However deciding which patients will benefit most from a defibrillator is tricky.

In a proof-of-concept study, published in the online journal Nature Communications, researchers from Johns Hopkins University (JHU) found that the virtual heart outperformed other existing metrics for predicting future arrhythmias.

Implantable defibrillators can be a lifesaving technology for patients with heart arrhythmias, delivering electric pulses that can correct irregular heartbeats, restore normal heart rhythm and prevent sudden cardiac death. But according to the researchers many patients who receive them don’t need them.

“This non-invasive and personalised virtual heart-risk assessment could help prevent sudden cardiac deaths and allow patients who are not at risk avoiding unnecessary defibrillator implantations,” said Professor of Biomedical Engineering at JHU, Natalia Trayanova.

The team used MRI scans of the patients’ hearts before they received the implanted defibrillator to build patient-specific digital replicas of the organs. Using computer-modelling techniques developed in Trayanova’s lab, the geometrical replica of each patient’s heart was brought to life by incorporating representations of the electrical processes in the cardiac cells and the communication among cells.

This method allows researchers to factor in the geometry of the patient’s heart, the way electrical waves move through it, and the impact of scar tissue left by an earlier heart attack to gauge the risk of sudden cardiac death due to arrhythmia.

“This is a ground breaking proof-of-concept study for several reasons. As cardiologists, we obtain copious amounts of data about patients, particularly high-tech imaging data but ultimately we use little of that information for individualised care,” said Associate Professor of Medicine at JHU and Co-author for the study, Katherine C. Wu.

“With the technique used in this study we were able to create a personalised, highly detailed virtual 3D heart, based on the patient’s specific anatomy. Then we were able to test the heart virtually to see how irritable it is under certain situations, we could do all this without requiring the patient to undergo an invasive procedure. This represents a safer, more comprehensive and individualised approach to sudden cardiac death risk assessment,” concluded Wu.

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