Heart Disease

Lead Researcher: Prof Martin Wilkins

Supported by the Cardiovascular Theme

Imatinib is used to treat certain blood cancers and there is interest in using this drug as a treatment for pulmonary arterial hypertension (PAH). A previous study has shown that doses as high as 400mg daily have a beneficial effect on blood pressure in the lungs of patients with PAH but not many patients tolerate these doses. We looked at the safety, tolerability and usefulness of lower doses of imatinib (100mg to 400mg daily) in a small group of patients, some of whom had sensors implanted in their pulmonary arteries providing daily measurements of the blood pressure in their lungs. The study showed that doses lower than 400mg daily are better tolerated and also reduce blood pressure in the lungs in patients with PAH with a dose-dependent relationship. The inclusion of patients with sensors implanted in their pulmonary arteries provided a more detailed picture of the time course of response and the data collected from this study will be useful in building a computer model (a digital twin) of how the heart and blood vessels in the lung respond to drug treatment. It is hoped that this computer model will help personalise the treatment of patients in the future.

Lead Researcher: Prof Prapa Kanagaratnam

Supported by the Cardiovascular Theme

Atrial fibrillation (AF) is a common heart condition where the heart beats irregularly, often leading to symptoms like palpitations, shortness of breath, and fatigue. If left untreated, AF can increase the risk of stroke and other serious complications. One of the most common treatments for AF is a procedure called ablation, where doctors use specialized equipment to treat the areas of the heart that cause these irregular beats. However, current ablation procedures are not always successful, especially in complex cases.

Our project has focused on developing the Tau20 system, a new technology designed to improve the effectiveness of AF treatments. The Tau20 system combines advanced hardware and software, including a unique tool called RETRO-Mapping, which helps doctors identify the specific areas in the heart responsible for causing AF. This technology has the potential to make ablation procedures more accurate and effective for patients.

Key Achievements:

1. Integration into Clinical Settings:
   The Tau20 system was successfully integrated into the Cardiac Catheter Laboratory at Imperial College Healthcare NHS Trust. Working closely with a clinical team, we connected the system with other key medical instruments and collected electrogram data from 15 AF patients. This data is currently being analysed and will be used to further refine the system for future clinical applications. While the Tau20 system has not yet been used during ablation procedures, the integration and data collection represent important steps toward making the system ready for clinical use.
2. RETRO-Mapping Technology for Ablation Guidance:
   We applied the RETRO-Mapping software, which is part of the Tau20 system, to identify the areas of the heart causing AF. The software was updated with a new, user-friendly interface that allows clinicians to pinpoint these areas with greater accuracy during ablation. Although not yet used directly in patient procedures, this tool holds promise for improving how doctors treat AF, making it easier to target problem areas and potentially enhancing patient outcomes.
3. Development of a New Algorithm Using Machine Learning:
   A new version of the RETRO-Mapping algorithm was developed using machine learning techniques. This updated algorithm has significantly reduced the time needed to process the heart’s electrical signals, making it quicker to identify the problematic areas causing AF. Although this progress is promising, further funding and research are required to explore the use of deep learning to improve the system’s real-time performance. More data is also needed to fully optimize the technology and ensure its effectiveness in guiding ablation procedures in clinical practice.

Looking Ahead:

Our work on the Tau20 system represents a major step forward in using technology to improve AF treatment. By making ablation procedures more precise and efficient, this technology has the potential to benefit many AF patients. We are committed to continuing our research, improving the system’s capabilities, and eventually making it available for wider use in hospitals, which could lead to better outcomes and quality of life for patients with AF.