First heart patients diagnosed using new fibre optic technology

New diagnostic technology that uses fibre optics to find the causes of heart disease has begun clinical testing at London’s St Bartholomew’s Hospital.

The iKOr device, developed at Barts Health and University College London, measures blood flow around the heart. Researchers say it could eventually help many thousands of patients suffering from cardiovascular symptoms such as chest pains, whose cause cannot be identified with current techniques.

“This new device is a game-changer in how we manage heart disease, making it a lot easier to assess the health of a person’s heart,” said Anthony Mathur, clinical director for interventional cardiology at Barts.

Three patients have so far undergone the new iKOr procedure, which is particularly suited to finding problems with their “microvasculature”. These tiny blood vessels do not show up well in the angiograms typically used by cardiologists to image the heart’s larger arteries.

Margaret Green, 75, one of the three pioneers, told the Financial Times the procedure “was a strange feeling but not uncomfortable”. She suffers from angina and shortness of breath.

“Now I feel great. I found out that I have something I’d never thought about: microvascular disease,” added Green. “It’s brilliant that this research is being carried out in the NHS.”

Once identified, microvascular disease — in which blood vessels narrow and thicken — can be treated with specific drugs that would not be prescribed without a diagnosis.

The iKOr device has a temperature and pressure sensor that is just 0.2mm wide — or twice the thickness of a human hair — which is threaded through the patient’s blood vessels on an ultra-thin catheter.

It measures the flow rate around the heart by flashing a brief pulse of light upstream of the vessels under investigation, which warms the blood there by about one degree.

The sensor detects the time taken for the temperature to change downstream, from which the device can tell whether the flow is obstructed by narrowing of the vessels.

Medical physicists and engineers at University College London invented this fibre optic sensing technology. In 2019 they set up Echopoint Medical to commercialise it in partnership with Barts.

Malcolm Finlay, consultant cardiologist at Barts and Echopoint’s chief medical officer, said the spinout company had so far received £2.3mn in equity funding from venture capital firms Albion Capital and Parkwalk, plus £1.8mn in grants from the government agency Innovate UK.

“This shows the real, tangible benefit that collaboration between NHS hospitals and universities can have for patients,” said Finlay. “It’s a great example of why it’s important to carry out research in the NHS.”

The first phase of clinical testing will involve 10 patients and is likely to have finished by the end of May. Then, subject to regulatory approval, there will be a larger trial with 100 patients, Finlay said.

He estimated that the device would be commercially available in the NHS in three years’ time. Echopoint will then take the technology overseas.

The procedure will add only slightly to the cost of a standard angiogram, said Finlay, adding: “We believe that savings from personalised diagnosis of patients will vastly offset any costs of using the device.”

Several hundred thousand patients a year worldwide could benefit from the technology, he said — particularly women, in whom microvascular disease is more common than men.

Colin Berry, professor of cardiology and imaging at the University of Glasgow, who was not involved in the UCL/Barts research, welcomed the new technology, saying: “It could provide clinicians with a simpler and quicker way to diagnose microvascular angina.”