Assessment and Treatment of Ischemia in Non-Obstructive Coronary Artery Disease (ATINOCA)
Portable ECG device and AI are used to early diagnose heart patients with chestpain instead of receiving invasive heart catheterization
Ischemia and non-obstructive coronary artery disease (INOCA) is a prevalent yet often neglected condition, particularly affecting women with chest pain symptoms. This disorder leads to a significant decline in quality of life and imposes a considerable economic burden on society. Recognizing its clinical significance, recent ESC guidelines for chronic coronary syndromes advocate for additional coronary functional testing to better understand the underlying mechanisms of INOCA.
Previous research indicates that confirming a diagnosis enhances patient compliance and treatment adherence, as demonstrated in the SCOT Heart trial. Our project posits that immediate electrocardiogram (ECG) recordings during symptom episodes in daily life at home can identify ischemic changes, offering a non-invasive strategy for guiding therapy in INOCA patients.
HeartEye has developed a miniECG device that records a 12-lead ECG using only four dry electrodes, set to launch for healthcare professionals in early 2025. This device has been clinically validated in collaboration with UMC Utrecht and Meander Hospital. We are also working on AI algorithms for automated ECG interpretation. Future iterations of this device will cater to consumer use, necessitating adaptations in device design, recording methods, app integration, data storage, and interpretation.
We will test two primary hypotheses: first, that modifications to the miniECG system will enhance diagnostic accuracy for ischemia detection; second, that ECG recordings during symptomatic episodes will strengthen the link between symptoms and ECG changes, thereby improving treatment outcomes for INOCA patients. The project will be executed over 24 months through two work packages: WP 1 focuses on adapting the miniECG system for home use, while WP 2 involves a clinical trial assessing the impact of home monitoring.
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