Researchers have developed virtual representations of patients’ hearts affected by disease, allowing doctors to observe and address dangerous irregular heartbeats in these digital models, which could lead to improved treatment for actual patients.
Preliminary results from a small clinical trial indicate that these custom models might enhance management of ventricular tachycardia—a challenging arrhythmia responsible for roughly 300,000 cardiac arrests in the U.S. annually.
This study, conducted by scientists at Johns Hopkins University, marks an initial step. The FDA authorized the use of digital twin technology for treatment in just 10 patients, emphasizing the need for larger trials to validate the findings.
The results, published in the New England Journal of Medicine, arrive at a time when healthcare professionals are increasingly considering how innovations from industries like aerospace can enhance medical practices.
Dr. Jeffrey Goldberger, a heart specialist at the University of Miami who wasn’t part of the study, reflected on past simpler models he worked with 15 years ago and expressed enthusiasm about the new developments, stating, “This is what we envisioned.”
While physicians have traditionally used both physical and digital 3D models to simulate diseases and refine techniques, biomedical engineer Natalia Trayanova highlighted that true digital twins can predict how a heart might respond to various treatments. Her lab is working on advanced, interactive models crafted from detailed MRI scans and other patient-specific data.
“We treat the twin before we treat the patient,” Trayanova explained. “Did it work? And if it did, are there new issues that arise requiring different care?”
The heart’s electrical system coordinates its beat, but in the case of ventricular tachycardia, a rapid heartbeat occurs due to an electrical disruption in the lower chambers, halting effective blood circulation.
“You see this heart that is basically quivering,” Trayanova noted.
While medication can help, ablation—where catheters are used to destroy problematic tissue—is the primary approach, often involving trial and error. Patients commonly undergo lengthy procedures under anesthesia as doctors search for the precise areas to target, leading to repeat ablation procedures and many individuals needing defibrillators as backups.
Enter Trayanova’s innovative digital twins of patients’ ventricles, which display vibrant colors illustrating the heart’s electrical activity. The visualizations help identify healthy sections and pinpoint damaged areas where the electrical signals get caught, akin to a whirlwind pattern.
“It enables me to recreate how the patient’s organ functions and predict the optimal ablation method,” she stated.
This technology allows the identification of malfunctioning areas where electrical waves frequently collide. By simulating an ablation, one can determine if the issue is resolved or if new arrhythmias arise, which could then require additional treatment. “Then we poke it again,” she added.
The team tailored ablation targets for each of the 10 participants in the study. Cardiologists utilized these precise targets in a mapping system, directing their efforts to those specific areas rather than searching broadly.
Over a year later, eight patients remained free from arrhythmias, with only two experiencing a brief episode during recovery—an improvement over the typical 60% success rate seen with this treatment, according to Dr. Jonathan Chrispin, a cardiologist at Hopkins and the study’s lead author. Nearly all participants also ceased their anti-arrhythmia medications.
More importantly, it seems that doctors could potentially remove less tissue by focusing on key problem areas, making procedures shorter, safer, and more effective, Chrispin explained.
The team at Hopkins aims to expand this digital twin research in larger studies involving other hospitals, and they’ve initiated trials for treating atrial fibrillation, a more common irregular heartbeat. Other investigations are also exploring digital twins in cancer treatment.
