Nicollier-Schlegel SARL

19/11/2024

Below is a series of seven, brief informational videos on clinical A-ECG that were recorded several years ago, but that are still useful for A-ECG teaching purposes. Video 1 just shows what a “normal, healthy heart” looks like by A-ECG, to provide that necessary background.

The next five videos thereafter then show both the conventional 12-lead and A-ECG results for patients with different heart pathologies, specifically for patients with coronary artery disease (video 2), non-ischemic cardiomyopathy (video 3), left ventricular hypertrophy (video 4), genetic hypertrophic cardiomyopathy (video 5) and genetic long QT syndrome (video 6), respectively.

Some of the cases with disease were specifically chosen because they illustrate how conventional 12-lead ECG is often “falsely normal”, or only non-specifically abnormal, in the context of major underlying heart disease, whereas at the same time, A-ECG is readily able to identify as well as specifically characterize the given disease. The seventh and final video “pulls everything together”, both statistically and through our standard clinical A-ECG display, showing where each patient’s result ends up on that display.

Video 1: A-ECG results in a healthy patient:
https://www.youtube.com/watch?v=kHdQAG-Mqak

Video 2: A-ECG results in a patient with single-vessel coronary artery disease (see Video 7 for her final diagnostic characterization): https://www.youtube.com/watch?v=A9qbiHy15CU

Video 3: A-ECG results in a patient with non-ischemic cardiomyopathy (NICM) and low cardiac ejection fraction (see Video 7 for his final diagnostic characterization): https://www.youtube.com/watch?v=3ROsbYD0xbA

Video 4: A-ECG in a patient with left ventricular hypertrophy (due to aortic stenosis, see Video 7 for his final diagnostic characterization, noting that his data come from a standard 10-sec ECG, not from a higher fidelity, ~5-min ECG): https://www.youtube.com/watch?v=E4e9wYdrXrk

Video 5: A-ECG in a patient with genetic hypertrophic cardiomyopathy (see Video 7 for his final diagnostic characterization, noting that his data come from a standard 10-sec ECG, not from a higher fidelity ~5-min ECG): https://www.youtube.com/watch?v=e9ZGopaz_g8

Video 6: A-ECG in a patient with genetic ion channelopathy (long QT syndrome; see Video 7 for his final diagnostic characterization, noting that his data come from a standard 10-sec ECG, not from a higher fidelity ~5-min ECG): https://www.youtube.com/watch?v=ge-LzFp7rcs

Video 7: The specific “disease calls” for each of the above patients by A-ECG, after appropriate statistical analyses, and as shown on the final diagnostic display: https://www.youtube.com/watch?v=j37h1NxMbpE

made with ezvid, free download at http://ezvid.com

13/11/2024

Our latest peer-reviewed publication, dated 09 October 2024. This one describes one of our newer advanced ECG methods that also allows us to "Heart Age Score" the conventional 12-lead ECGs of patients who are in atrial fibrillation or who otherwise lack definable P waves. While this is actually something we've been doing now clinically for some time, it's great to have both the methods and the related rich results (i.e., the clinical utility of this newer score for predicting cardiovascular events) described in such exquisite detail so that others can make use of them. Congratulations especially to Dr. Zaidon Al-Falahi, from the University of Sydney in Australia, for his outstanding first-author work on this publication.

https://academic.oup.com/ehjdh/advance-article/doi/10.1093/ehjdh/ztae075/7816279?login=false

17/05/2024

Our latest peer-reviewed publication (April 2024). This one is especially focused on the use of advanced ECG (A-ECG) to more accurately identify apical hypertrophic cardiomyopathy via standard 12-lead ECG than has been previously accomplished. The more general, overall diagnostic performance of A-ECG for distinguishing, via standard 12-lead ECG, multiple types of heart diseases from one another and from health, especially via A-ECG-related linear discriminant analysis (LDA) as clinically practiced today, is also discussed within this publication, specifically within its Tables 4 and 5 and Figure 2 and related text. Congratulations to Dr. Rebecca Hughes, from University College London, for her outstanding first-author work on this publication.

AbstractAims. Typical electrocardiogram (ECG) features of apical hypertrophic cardiomyopathy (ApHCM) include tall R waves and deep or giant T-wave inversio

18/08/2023

Our latest A-ECG publication, published in the European Heart Journal (Digital Health) on 25 July 2023, and titled "Heart age gap estimated by explainable advanced electrocardiography is associated with cardiovascular risk factors and survival", is now freely available online.

The study's main take home points are first, that an increased A-ECG Heart Age Gap, as ethically quantified via transparent, explainable, human-guided machine learning processes that can now be automatically applied to standard 12-lead ECGs, is associated with increased risk of incident heart failure hospitalization and death, as well as with the presence of cardiovascular risk factors. Moreover, this gap is more powerful than a "deep neural network, artificial intelligence ECG-based" ("DNN-AI ECG") heart age gap when the results of both techniques are applied blindly to the same independent ECG data set.

For those with a truly deep (pun intended?) interest in this topic, suggest that one especially focus on the long, penultimate paragraph of this publication's Discussion section, centered around its Figure 3. A main, additional, take-home point from that is that extant "DNN AI-ECG age" techniques are not really “estimating ECG age” at all. What they are instead doing is attempting to use raw ECG data to estimate patients' CHRONOLOGICAL ages via their DNNs, a subtle but important distinction. And because they do that and because of certain other critical methodological oversights (see our publication for details), they also systematically over-estimate "ECG age" in youthful persons and systematically under-estimate "ECG age" in elderly persons.

A big congratulations to my Swedish colleague Dr. Thomas Lindow for his outstanding first-author work on this publication.

AbstractAims. Deep neural network artificial intelligence (DNN-AI)–based Heart Age estimations have been presented and used to show that the difference between

15/06/2022

Our latest A-ECG publication, related to estimating the Heart Age and the "Heart Age Gap" by 10-sec 12-lead ECG, has just been published in Nature (Scientific Reports). Congratulations especially to Dr. Thomas Lindow for this excellent work.

Electrocardiographic (ECG) Heart Age conveying cardiovascular risk has been estimated by both Bayesian and artificial intelligence approaches. We hypothesised that explainable measures from the 10-s 12-lead ECG could successfully predict Bayesian 5-min ECG Heart Age. Advanced analysis was perfo...

06/02/2021

This post begins our new “Spotlight A-ECG Case” series, wherein on occasion we will begin featuring individual, de-identified clinical A-ECG-related case reports for demonstration and teaching purposes.

This first spotlighted case is a typical type that we now very frequently observe. It features a generally asymptomatic middle-aged woman with cardiovascular risk factors (“Jane Doe”) who returned, after approximately 1 year, for a follow-up A-ECG test. During her first visit to the clinic ~1-year prior, she had had an A-ECG result that likely suggested the presence of some degree of coronary artery disease and/or coronary microvascular disease (CMVD). And perhaps a mild degree of left ventricular electrical remodeling (LVER) as well, LVER often (although not always) being associated with anatomical left ventricular hypertrophy. Her “Age score” by advanced ECG was also notably higher, by 15+ years, than her true chronological age. However, she showed no overt signs of heart failure (left ventricular systolic dysfunction, LVSD) by A-ECG during her initial visit.

Per her follow-up Advanced-ECG Report ~1-year later, accessible in PDF via the link below, along with her conventional 12-lead ECG reports, the electrical condition of her heart notably improved after a year’s worth of following the intelligent, personalized preventive approach implemented by her supervising clinician(s) at the Edison Clinic in Auckland, NZ. Moreover, her “Age score” by advanced ECG also notably improved, almost coming back into line with her true chronological age, after the year’s worth of following Edison’s specialized preventive regimen. This case is an excellent one for demonstrating the clinical utility of “serial A-ECGs” in an outpatient setting, both for following clinical progress, and also for patient motivation and encouragement. https://www.dropbox.com/sh/0n5zg5a3c8jyhnz/AAA1kpZUqYXEa63vRC7vpqF3a?dl=0
Note: for these Spotlight Cases, we’re also happy to answer questions and entertain collegial comments.

Shared with Dropbox

06/02/2021

For our local colleagues and friends in the French-speaking area of Switzerland: We're very pleased to announce the availability of A-ECG testing and reports via our colleague Dr. Philippe Tournesac, at the Integrative Medicine Institute in Nyon (Vaud). The Integrative Medicine Institute is conveniently located within ~20-min of the Geneva (GVA) airport. Dr. Tournesac's integrative approach to medicine has been repeatedly proven successful, and we also highly recommend Dr. Tournesac and his team for all of your integrative medicine needs.

13/07/2020

Congratulations to Dr. Maren Maanja, who successfully defended her A-ECG-related PhD thesis at Karolinska on 29 May 2020.

23/03/2020

"A little learning is a dangerous thing; Drink deep, or taste not the Pierian spring". (Our recent editorial in JAHA).

HomeJournal of the American Heart AssociationVol. 9, No. 7Going Deep With and Aortic Stenosis: Touchdown or Incomplete Pass? Open AccessarticlePDF/EPUBAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyRedd...

06/11/2019

We wish to welcome our latest partner and local provider of clinical A-ECG services, The Edison Clinic, located in Auckland, New Zealand. If you live in New Zealand and are interested in state-of-the-art personalized, precision medicine and/or in having an A-ECG performed, we would highly recommend Edison to you. https://www.edisonclinic.com/