It’s no secret that the heart has one of the most important jobs in the human body. Every day, this critical muscle beats 100,000 times, pumping gallons of freshly oxygenated blood to organs via the circulatory system.
Sometimes, however, the muscle can weaken over time, making it difficult to perform this essential task. The resulting condition, heart failure, affects millions and claims hundreds of thousands of lives throughout the U.S. each year.
Fortunately, Dr. Jeffrey Holmes, professor of biomedical engineering and medicine, and Dr. Kenneth Bilchick, a cardiologist, with support from a family foundation, are developing software that will allow physicians to make better-informed decisions when treating some people who suffer from the condition.
The technology supports cardiac resynchronization therapy (CRT), a procedure in which clinicians implant a pacemaker or pacemaker-defibrillator in patients’ chests to re-establish the normal coordinated beating of the heart’s main pumping chambers. Performed successfully, CRT “resynchronizes” the heart, enabling it to pump blood more strongly and efficiently and promoting favorable changes in the organ’s structure. Having existed since the 1990s, the therapy has helped many. Too often, however, patients do not experience the full potential benefit of CRT due to variables that are difficult for doctors to assess.
“To see results,” Holmes explained, “some patients require custom placement of the stimulation wires, as well as other personalized device settings—and the potential permutations are endless.”
While most would assume a sophisticated methodology exists to assist doctors in making these crucial decisions, currently, clinicians must rely for the most part on experience, evaluating multiple approaches until they find the best one. This often adds time to the procedure without guaranteeing an optimal solution. “What happens now is that the clinician will use common locations based on what they think might work, taking into account test results and previous heart attacks,” Bilchick said.
“In this method, a little more than half of patients meet the usual standard for response. We believed we could increase that rate substantially with our technology.”
So the pair got to work. Partnering with a team of engineers, graduate students, and postdoctoral fellows, they created a platform that models the heart in 3D, using the unique structure of each patient’s heart to predict how the organ will respond to pacemaker configurations over time. The best part? It runs on a desktop PC in minutes.
“It’s exciting technology,” Holmes said. “With this level of analysis, we’re effectively able to predict the heart’s growth over months or even years.”
Throughout the development process, the researchers benefitted greatly from the talent and resources available at the School of Engineering and Applied Science and the School of Medicine. Early on, they were also delighted to receive some unexpected private support.
“I was speaking in front of a group at UVA’s Heart and Vascular Center,” Holmes said. “After my talk, a colleague approached me to let me know he was working with a family foundation that might be interested in what we were doing.”
Holmes and Bilchick submitted a proposal, and the foundation approved it, providing critical early support for the project.
While much work remains before the Food and Drug Administration will approve the technology, the team is optimistic about the future and eager to see their software put to use.
“We’ve still got plenty to do,” Bilchick said. “We have to prove that it works locally, and we’ll need to secure additional funding for clinical trials. But we’re excited about how many lives this could impact.”