Leading the ECG Analysis Wave

Dr. David Hadley

Senior VP of Research & Development

 

Dave Hadley, PhD, Senior VP of Research & Development

Driving accessibility and adoption of the next generation ECG technology

 

Waves, whether transmitted through bedrock or heart muscle, often forecast future events. But you must know how to listen and leverage the right technology. Analyzing waves to understand source characteristics has always fascinated me.

My career has its very early foundation in what’s under our feet, not beating in our chest. I started my career as a seismologist. The underlying physics associated with seismic waves are very similar to the electrical waves pulsing through cardiac muscle.

For the heart, electrical waves are created as the depolarization wave front – which triggers the heart to contract – propagates through the heart muscle. By coupling the right equipment with the relevant expertise we’re able to interpret information from these waves which may warn of future cardiac events.

It’s this fascination with the predictive value of waves which led my career trajectory. As the Senior VP of Product Development at Cardiac Insight, I now pioneer advanced digital health tools including ECG wearable devices and  comprehensive and robust analysis software that are revolutionizing diagnostic care. Diagnoses that historically required the use of a bulky Holter device and extensive lag time for outsourced data analysis can now be completed in a fraction of the time and at much lower costs at the point of care.

Timeliness to a diagnosis is significant as physicians see increased prevalence of Atrial Fibrillation (AFib), and outsourcing ECG data analysis burns valuable time to treatment, knowing those with AFib present a higher risk of stroke.

After our Cardea SOLO wearable ECG monitor is worn by a patient, data analysis takes place in the clinician’s office. This simple step takes place in a matter of minutes, not days or weeks. This frees physicians to capture full reimbursement, without outsourcing expenses, and saves the precious time. But we’re not done innovating.

Without a doubt, the accelerating advances in computational power open new fields of research and innovation. Some of the robust algorithms we write today, that execute in seconds, would have required a Cray computer in the past.

When the clinical understanding of a problem is clear, an expert system such as our proven algorithms will significantly out-perform Artificial Intelligence (AI). For instance, the ECG characteristics of AFib are well understood: irregular RR intervals – or irregular time between beats – without complex repeating patterns and without P-waves. With this simple definition we’ve created an advanced algorithm that achieves ~95 % sensitivity. That beats current AI based algorithms by a significant margin. Recently a major AI study* was conducted to detect AFib – the resulting sensitivity was in the low 80% range.

We’re not discounting AI!  We are well positioned to use AI tools for the class of problems where clinical studies have heretofore been unable to connect the dots. For example, there is a belief that AFib is the end state in atrial complexity that begins with premature atrial contractions, atrial couplets, triplets, runs of supraventricular tachycardia, progressing to paroxysmal AFib, and finally into sustained AFib. AI tools may be very helpful for forecasting the risk and timing of future adverse outcomes based upon the patient’s current presentation.

Future Focused: Approaching a New Golden Age for ECG

Given the monitored history of a patient, and other clinical information, can we predict where they are in this progression?  When should they next be monitored?  When will they be at high risk for onset of AFib?  This is a great project we’re beginning to explore, employing new advancements in AI.

We’re also working with clinical researchers on complex projects, mining the ECG waveform and patterns for predictive algorithms. With widespread digital recording, and voluminous clinical insights, more could be done to improve interpretation that accounts for changes caused by gender, ethnicity, age, body habit, and clinical presentation.

There is much work and opportunity ahead. Powered by breakthroughs in computational power and coupled with technological advances, I believe Cardiac Insight is positioned to lead the new golden age of ECG.

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ABOUT DR. DAVE HADLEY: Dave Hadley, PhD, serves as the Senior VP of R&D for Cardiac Insight. Dr. Hadley has over 30 years of hands-on experience blending customer needs with information technology through research and development. He spent nine years as Vice President of Research and Development for Quinton Cardiology. In this role, Dr. Hadley was responsible for rebuilding the engineering team, establishing robust new product architectures and developing the next generation of Quinton and Burdick diagnostic ECG products. Prior to his role at Quinton Cardiology, Dr. Hadley was with Primus Knowledge Solutions and Sierra Geophysics. He earned his PhD from the California Institute of Technology and has authored, or co-authored dozens of papers published in peer reviewed journals relating to ECG technology.

*source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31721-0/fulltext