Heart digital twins improved ablation outcomes for patients with life-threatening arrhythmias in the first clinical trial of the technology.
The research was carried out at Johns Hopkins University in the US.
Arrhythmias are abnormal heart rhythms that can be dangerous or fatal. They are typically treated with ablation, which destroys tissue that triggers the irregular electrical signals.
But it can be hard for doctors to pinpoint the right spot, procedures can be lengthy, and arrhythmias often return.
Medical digital twins are computer models of organs that mimic how they behave and can help doctors test treatment options before treating the patient.
Jonathan Chrispin, a cardiologist and first author of the study, said: “For patients, digital twins can be life-changing and life-saving.
“We show we can make their procedures safer, shorter and more effective by targeting only the critical portions of the heart.”
In the trial, researchers created digital replicas of patients’ hearts and tested procedures on those twins before carrying them out in real life.
The approach resulted in faster and more accurate procedures that reduced recurrences of arrhythmias compared with traditional methods.
Ten patients took part in the FDA-approved TWIN-VT trial. All had experienced heart attacks and had ventricular tachycardia, an abnormally fast heartbeat that can be life-threatening.
For each participant, the team created a personalised digital twin of the heart using 3D imaging from a contrast-enhanced MRI scan.
Through the digital twins, the researchers studied how each heart processed electricity and predicted which area was provoking the arrhythmias, the best way to treat each patient, and whether the arrhythmia would return after ablation.
These predicted targets were then imported into a system that guides the ablation catheter, a thin tube used to deliver treatment inside the heart, in the procedure room.
After the ablations, doctors could not stimulate arrhythmias in any of the 10 patients, indicating the procedures had worked.
Two patients experienced a brief episode while healing. More than a year later, all 10 remained arrhythmia-free. The long-term success rate with traditional ablation is about 60 per cent, compared with 100 per cent in this trial.
Eight patients were entirely off anti-arrhythmia medication and the remaining two had reduced their doses.
Natalia Trayanova, senior author and professor of biomedical engineering, whose team developed the digital twin technology used in the trial, said: “In the patient’s digital twin, we can try different scenarios for treatment before we treat the actual patient and provide the treating physician with the best, most optimal scenario, minimising damage to the heart, and increasing the potential for a successful treatment.
“The digital twin allows us to address all potential sources of arrythmias that may not be seen by clinical interrogation. We exhaust all possibilities.
“We show the technology isn’t merely feasible, it has excellent outcomes.
“This demonstrates a crowning achievement in this technology that allows us to go further toward a larger clinical trial.”
The team expects to test cardiac digital twins in a larger trial.
It is also working to make the technology accessible on a desktop computer, which would get information to doctors in minutes, and plans to expand it to other cardiac diseases.
