March 29, 2019
Mayo Clinic's cardiovascular team is focusing on improving patient care through artificial intelligence (AI) by deploying Mayo-developed algorithms for heart monitoring and arrhythmia detection in a novel approach: heart monitoring via sensors embedded directly in the fibers of clothing. ECG-enabled textiles are a new form of wearable medical technology giving rise to the era of smart heart clothes.
Early detection of atrial fibrillation
Smart heart clothes hold the potential to offer preventive, 24/7 heart rhythm monitoring remotely, and to detect rhythm abnormalities early. The rapid interventions this makes possible can significantly improve the ability to detect conditions such as atrial fibrillation in order to get patients treated sooner.
"Mayo Clinic certainly reads and processes a lot of pertinent heart rhythm data, but all these generally require patients to be on-site at a Mayo location to hook up the equipment," says Peter A. Noseworthy, M.D., the Mayo cardiovascular AI team member who heads Mayo Clinic's Heart Rhythm and Physiological Monitoring Laboratory, and specializes in the pathophysiology and management of atrial and ventricular arrhythmias.
Dr. Noseworthy is especially encouraged by the potential for remote health data transmission to improve care. "With ECG-enabled clothing, our practice won't be restricted to patients who visit a Mayo Clinic site. We'll send patients an ECG-enabled shirt anywhere in the world and the data will transmit back to us digitally. It could considerably increase our ability to reach patients around the world, make recommendation to those who can be treated remotely and identify those who might benefit from traveling here for our services."
Reliable, convenient, comfortable
Smart heart clothing is intended to replace the Holter monitor, a portable ECG monitoring device that hangs from the neck or belt and requires multiple adhesive electrodes to be attached to the skin for several days or weeks.
"It's not a space that has had a lot of innovation," Dr. Noseworthy says. "If you look at the Holter monitor, the technique most patients are familiar with today, it is basically unchanged from 20 years ago."
For decades, Mayo Clinic has carefully curated and annotated patient biodata. The Mayo Clinic cardiovascular AI team has access to millions of data points within a database on heart rhythm function. Its AI experts used that data to design and train algorithms that analyze patients' heart function. Algorithms are a set of commands that instruct a computer to classify and identify patterns and interactions in data and to continually refine the analysis.
Machine learning is the AI specialty that focuses on developing algorithms. Mayo Clinic's cardiovascular AI team in the smart clothing project used machine learning to design proprietary algorithms that belong to an algorithm type known as a convoluted neural network. This particular kind of network analyzes and parses data patterns that are deeply layered to make highly accurate predictions about who has risk factors for heart failure.
Says Dr. Noseworthy: "If, in the future, we are to be monitoring a massive number of patients — say, an order of magnitude more patients — then we need to have intelligent ways of analyzing that data for diagnosis and management. I anticipate that AI will play a big role in that."
The need for innovation
Current monitoring technology is limited by the following disadvantages, which ECG-enabled clothing seeks to overcome. Patients:
- Must travel to a health care center to get the device
- Undergo a procedure that requires affixing sticky electrical leads to the chest
- May need to have chest hair shaved prior to applying ECG connections
- Can risk having leads fall off, interrupting monitoring and diminishing data quality
- Face restricted movement, such as showering or other daily activities
As smart heart clothing development proceeds and prototypes are tested, Dr. Noseworthy envisions expanding the project. He sees benefit in embedding textile sensors to detect and record other health data, such as temperature, activity through step counts and respiration rate.
Over the next year, the focus is on resolving regulatory and manufacturing issues, ensuring data privacy is protected, and refining the software. But he's confident that smart heart clothes will be at the forefront of changing the way patients receive care. They will usher in an era of more accessible heart monitoring in which patients are comfortable and confident in both the quality of monitoring and the care it makes possible. "There's a lot of work that needs to be done to get this to being a practicing reality, but our goal is to transform and improve the way we monitor patients and manage disease," he says. "AI is a helping us do this quickly, safely and reliably."
For more information
Heart Rhythm and Physiological Monitoring Laboratory. Mayo Clinic.