Every heart has its own electrical 'fingerprint', Maastricht UMC+ research shows. Although heart films of healthy people are very similar, everyone's heart rhythm appears to go via a different route.
Job Stoks, a researcher at Maastricht UMC+, will receive his PhD on the subject on 22 February. Stoks combined heart films with anatomical images of the shape of the heart. In patients with cardiac arrhythmia, this combination helps to understand exactly what is going wrong, and where it is happening.
Which treatment produces the best results?
The heart pumps blood through the body. In the process, it receives electrical stimuli that cause it to contract. Disrupting the electrical activity of the ventricles can lead to life-threatening arrhythmias. Who is at risk of cardiac arrhythmias is difficult to predict, while it is also difficult to determine which treatment will yield the best results.
To better understand electrical properties, Stoks mapped the hearts of healthy people. This analysis showed that the electrical properties are different for each heart. Each heart therefore has its own electrical 'fingerprint', Stoks concludes. Among other things, the discovery explains why patients do not always respond the same way to the same treatment for cardiac arrhythmias.
'Are there traffic jams or is it moving through?'
"Imagine the electrical activity of the heart as cars driving along a road network," explains Stoks. "With a standard heart monitor, you can see if there are traffic jams or if it is moving well - in other words, if there are disturbances in the heart's electrical stimuli. A CT or MRI scan of the heart does not give electrical information, but is like a satellite photo with the pathways used by the electrical stimuli. By overlaying a much more comprehensive heart film over the CT or MRI scan, we can see exactly which roads are congested or delayed, and why."
This approach is also called electrocardiographic imaging (ECGI). With an ECGI, you can find the exact origin of a cardiac arrhythmia, and cardiologists can see exactly where in the heart they need to treat. Its use is currently still mainly limited to scientific research.
3D model of the heart
Stoks extended this technology further. And made a 3D model of the heart of a patient with a life-threatening arrhythmia. "We used certain protocols to also image the heart tissue," says Stoks. "In a 3D heart, for example, we can see where scar tissue is, and how it disrupts the pathway or speed of electrical activity through the heart. It's like zooming in on the satellite image to see the quality of the road surface, and seeing where congestion or accidents occur in traffic."
The method is expected to be of great benefit. For instance, ECGI and the 3D model do not require surgery, which saves complications and costs. If it turns out that patients can be treated with drugs or radiotherapy of the heart, it means no surgery is needed. "But we are not that far yet," notes Stoks. "Our research shows that it is possible to combine different non-invasive measurements and that we can see much more than with each of the methods separately. Before we can use this for personal diagnostics and treatment in the clinic, more research is needed, but we are moving fast in that direction."
Author: Wouter Hoeffnagel
Photo: PublicDomainPictures via Pixabay
