LifeMap: towards the development of a new technology in sudden cardiac death risk stratification for clinical use

Sudden cardiac death (SCD) is a major cause of mortality presenting a significant unmet clinical need. Patients at risk of SCD are implanted with implantable cardioverter-defibrillators (ICDs) according to international guidelines based on clinical trial evidence. Implantable cardioverter-defibrillators are not inexpensive and not without problem in terms of inappropriate shocks and infection risk. Also, only a minority of patients implanted with the ICD ever use the device during its battery lifetime highlighting the fact that methods used for SCD risk stratification are inadequate. Better ways of predicting who is at risk of SCD are needed. In addition, there is no effective prevention due to the lack of understanding of the electrical mechanisms underlying SCD. Our group has been investigating the electrophysiological basis of ventricular fibrillation and have successfully applied our preclinical findings to translational studies in patients with ischaemic cardiomyopathy. We have developed two ECG markers which have been shown to be strong predictors of ventricular arrhythmias and SCD. Ongoing clinical studies are being carried out including a multicentre UK study to consolidate the evidence base. They are being incorporated into the technology, LifeMap, with the aim to develop a successful clinical tool for the assessment of SCD risk. We hereby present the scientific data leading to the technology and the development to date. The information provided here was presented at the European Heart Rhythm Association (EHRA) Europace/Cardiostim conference at which LifeMap won the EHRA Inventors Award 2016.