CineECG Revolutionizing Heart Disease Diagnosis in 3D

By Lisa Cornelissen

CineECG: Revolutionizing Heart Disease Diagnosis in 3D  

For most heart-related problems, an electrocardiogram, or ECG, is the go-to diagnostic tool. This test produces 12 lines, each representing the heart's electrical activity from a different angle. An easier way to interpret these signals is via 1 image that describes the whole activation of the heart in 3D: a CineECG.  

Physicians, including cardiologists and general practitioners, use ECGs as a crucial tool to detect conditions such as heart attacks and arrhythmias. The heart's primary function is to pump blood throughout the body, a process intricately tied to its electrical activity. The ECG captures this electrical activity and translates it into 12 lines, leads, that doctors analyse to understand heart function and detect abnormalities. For general practitioners this can mean the difference between referral to a hospital or sending the patient home. “An ECG is made for nearly all heart-related problems,” says Ton Gorgels, emeritus professor of cardiology at the Maastricht UMC+.  

 “The ECG is a 2D representation of the hearts electrical activity, which is a 3D whole. A lot of electrocardiologists look at every lead individually. This is where CineECG has the biggest gain:  

because it is one image, interpreting it is much faster,” Ton explains. Remarkably, CineECG can achieve this with just the standard 12-lead ECG and within less than a minute. “In principle, there is nothing more to see in CineECG than in a regular ECG, but it is clearer. In the normal ECG, changes of 1 mV can be significant but are very hard to see. In CineECG, these changes are obvious,” he says.  

Iris van der Schaaf of the UMC Utrecht researched CineECG’s potential in early detection of insufficient blood flow of the hearts arteries. “With CineECG, we can see deviations from a normal ECG of an ischemic heart before they are even detectable on the standard ECG,” she says. While they are confident about CineECG's ability to detect heart abnormalities, further research is needed to see if it does not falsely diagnose individuals with a healthy heart. This research involves using a larger cohort and considering risk factors for each patient.  

Peter van Dam programs the CineECG software and has analysed numerous normal ECGs to calculate an average ECG with a normal distribution. He even added a feature to the CineECG program that turns orange when an ECG deviates significantly from this average. “Not only can an ECG be compared  

to the normal population, but also to the normal for a specific patient. This helps in detecting significant changes that require action,” says Peter. He adds, “We are currently doing this with a database of 400,000 ECGs of children.” This allows CineECG interpretation of an even larger patient group.  

Looking to the future, the team envisions CineECG becoming widely available. “General practitioners could make the ECG and load it into the CineECG software. This visualisation makes it easier for the doctor to identify abnormalities and decide whether to refer the patient to a hospital,” they explain. According to them, CineECG is poised to transform cardiac diagnostics by offering a clearer and faster view of the heart's electrical activity.