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“Liquid ECG” A Game Changer for Heart Patients


Wed, 05/20/2020 - 12:00


Patients with a heart condition are used to travelling to the hospital to undergo an electrocardiology (ECG) test to measure the electrical activity of their hearts for detecting abnormal rhythms. But increasingly, patients have taken to ECG wearables that provide constant monitoring, allowing them to capture and send cardiac rhythm to doctors for review.

A cardiologist here has taken this development a step further by developing the world’s first medical grade ECG wearable that can transmit data continuously through a smartphone to a cloud database. Physicians can log in remotely and securely to their database and report their findings to patients. Developed by Dr Philip Wong, a senior consultant at the National Heart Centre of Singapore, the wearable, named Spyder, is the flagship product of startup WEB Biotechnology. Dr Wong is the Chairman and Medical Director of the startup.

“The Spyder ECG provides data fluidity world-wide and we use the term “Liquid ECG” with users of our system. With Spyder, we can see an individual’s ECG in the United States continuously here in Singapore ‘live’, just three to four seconds later,” Dr Wong says.

“The device is a game changer as its data can be sent by an individual and received by a doctor in any part of the world,” Dr Wong adds, “The small form factor of the device allows easy scalability, enabling any patient or healthcare facility in a data connected area to be monitored by a medical grade device.”

Tracking Your Heart Health with Ease

Dr Wong is a cardiologist tapping biotechnology to help improve patient care. He wants patients to have an easier and better test, and to improve the diagnostic accuracy of the current standard test— the Holter ECG Test.

Current Holter devices are wired devices that usually have no transmission capabilities. This means that a patient has to travel to the hospital to have the device attached to them, and then return to the hospital again, so that their data can be downloaded for analysis.

Spyder, on the other hand, is wireless and allows patients to transmit their readings onto a cloud database where physicians can immediately retrieve and assess the ECG data coming in. The device has been used in patients for up to 30 days, and this improves the diagnostic yield of sometimes short but dangerous cardiac arrhythmias. For instance, some dangerous arrhythmias such as paroxysmal atrial fibrillation can increase the risk of stroke by three to five times annually. Atrial fibrillation can begin with a short five to ten minutes burst, thus making single-day Holter ECG test ineffective in detecting them. A large proportion of symptoms also occur during sleep hours, making it unlikely for wrist-worn activated ECG monitors to detect these short bursts of arrhythmias.

The Spyder device weighs just 48grams. When attached to the chest it can transmit ECG data wirelessly to a mobile app and a cloud database.

Today, over 12,000 patients have used Spyder. 60 per cent of these are located outside of Singapore. What amazes Dr Wong the most is to see ‘live’ ECG signals being transmitted across the globe by patients using Spyder.

“This shows that Spyder is making a difference in patients’ lives regardless of their location,” Dr Wong says, “ECG signals coming from Indonesia, China, Russia, South America, the European Union, and the Middle East are all appearing in a screen in front of me.” He finds it particularly interesting that a standard smartphone, when properly enabled, can function as an ECG display and an interactive interface between a patient and a care provider located far away.

Dr Wong says that his team has responded to abnormal ECGs in patients hundreds of miles away and in some cases, these ECG showed abnormal rhythms that were life threatening. “In some cases, a simple text message to patients and their doctors have resulted in patients being admitted directly to hospital for critical procedures such as permanent pacemakers,” he says.

Rising Importance of Remote Cardiac Monitoring

Remote cardiac monitoring devices are gaining popularity among patients and healthcare providers due to their ease of use and tracking accuracy. Patients can receive the devices in hospitals, emergency rooms and primary healthcare clinics, and record their data prior to seeing a specialist.

Dr Wong believes that this “front-loading” of diagnostic test, compared to bulky and complex devices that need to be set up in hospital, can contribute significant savings in time and visits to hospitals.

“Specialists seeing a patient for the first time will have the health information of the patient on hand. They can therefore make correct clinical interventions and provide care plans without the need to order more tests,” he adds.

Remote cardiac monitoring can also benefit a group of patients with stroke or those who have undergone major heart surgery such as bypass heart surgery or heart valve surgery. Dr Wong says that these patients are currently not monitored after they are discharged from the hospital, and Spyder is now an option that allows such high-risk patients to be monitored during the recovery phase.

As the use of remote cardiac monitoring devices slowly gains traction, Dr Wong feels that Artificial Intelligence (AI) can play a significant role in analysing patients’ data to study trends and risks across different age and population groups for various cardiac arrhythmias. He has built a significant database of over 12,000 individual sessions and is planning to apply AI solutions on the datasets soon.

“We are very excited about the use of AI in streaming ECG data in our system. Based on the quality and quantity of data we receive from an individual, AI can be used to predict the onset of abnormal rhythms in an individual in the future,” he says.

Dr Wong is also concurrently refining Spyder’s diagnostics and monitoring system so that it becomes even more intuitive for patient use. “Such equipment is traditionally held at healthcare facilities, but we are optimistic that one day, all households in Singapore will have a high quality monitor to check the heart,” he says.

Staying Focused on One’s Goal

Dr Wong said an entrepreneur’s journey is filled with difficulties, so there is nothing more important than to focus on building a product that has value and helps people.

“To get any product to commercial viability, you have to keep going no matter what the circumstances are,” he says. Now, Dr Wong finds it most satisfying that he is improving the lives of heart patients from around the world. “Although the product was complex to conceptualise and build, it is now simple to use, and has improved the lives of many patients,” he adds.

This article was first published on National Research Foundation’s RIE News Magazine. At SGInnovate, we work with entrepreneurial scientists to build and scale their companies.

WEB Biotechnology is one of our portfolio companies.


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