Artificial intelligence to detect heart attacks in a timely manner is close at hand

Hospital mortality due to acute myocardial infarction (AMI) in Mexico is three times higher than the average of the countries of the Organization for Economic Cooperation and Development (OECD): 28.1 versus 7.5 deaths per 100 discharges in patients 45 years of age and older.

In 2020 AMI caused 117,000 deaths and there is no indication that the death rate is decreasing. Hence the importance of early detection of any cardiac abnormality such as thrombosis of a coronary artery. Currently 25 to 34% of cases can be undiagnosed, mainly in patients without typical findings on the electrocardiogram.

The problem is that the tools used today for early detection are limited. Currently, it can only be confirmed if a patient has a clot in the coronary arteries by introducing a catheter through the femoral artery, traversing it and crossing that device to the aorta and there shooting a contrast liquid into the coronary arteries.

Given this reality, there are efforts to incorporate the artificial intelligence to the cardiology area in order to prevent and detect in time the patient with any abnormality and, therefore, risk of coronary thrombosis.

The doctor. Diego Araiza, a cardiologist attached to the Department of Coronary Care and Emergencies of the National Institute of Cardiology, made the presentation of the project within the framework of Mexican Congress of Cardiology held in November 2021 in Mérida, where 1,850 cardiologists and specialists attended and another 3,500 were online.

In an interview with The Economist, the specialist explained that this project that uses artificial intelligence and deep neural networks implies giving cardiologists a tool to automatically identify patterns in the electrocardiogram to detect coronary thrombosis in the first minutes and prevent many deaths.

“Even the best of cardiologists is subject to the interpretation of the electrocardiogram, but with this technology that uses a specialized algorithm can give higher diagnostic yields of a heart attack and save the life of the patient through catheterization”, indicated the specialist.

For its part, Pilar Espinosa, director of Astra Vision, a technology company that has been developing its artificial intelligence platform for years, said that although there is still uncertainty in the application of these digital health options, when the tool is shown to work, there will be a disruption in cardiac care. You will be able to take an electrocardiogram, the net cost of which will range from 20 to 25 pesos and it will take between 10 and 15 seconds. Well, it simply involves “taking a photo, analyzing it using an algorithm or software on our cell phone to determine if the patient has a clot inside his coronary arteries and we have a prompt diagnosis with a certainty of 98%”.

“This technology saves time, the performance of potentially harmful procedures, gives accessibility to information and does not depend on a group of highly specialized cardiologists,” said Dr. Araiza, an active member of the Mexican Society of Cardiology.

He explained that they are currently in the validation and derivation of an algorithm for the electrocardiogram machines that are digitized to make a computational analysis. It is being evaluated if it will be an application and with it facilitate the diagnosis to doctors in remote areas, even those who require a second opinion.

He mentioned that there is another called Cardio Enlace that will benefit patients, which allows daily vital signs of people to be recorded, in addition to having variables such as weight, physical activity or abdominal circumference.

Another application called healthy heart is for training and education for patients on the risk factors that can contribute to developing heart disease. These have been developed independently, but the idea is that they come together, this will be in a next phase.

The businesswoman Pilar Espinosa pointed out: “We have been working on technology and artificial intelligence in a general way and now we are focused on health issues. There are many algorithms internationally that can detect diseases early. We know that the National Institute of Cardiology has good doctors, but it is not a reality in all hospitals in Mexico, with the new option with AI it will be possible to catalyze the diagnosis early ”.

He noted that in this process he is supporting them Edgar Roman, PhD in Computational Sciences, who has provided information on neural networks and images for this project, they are using all electrocardiograms for research and development and through algorithms and computational technologies that already exist, a database of images and information can be made that serve Mexican doctors.

Currently, more than 300 electrocardiograms have been analyzed and digitized in an initial phase. “You can capitalize on all this computational muscle and use it in the detection of conditions that the human eye does not see.”

The project is a conjunction of efforts between the National Institute of Cardiology, the Mexican Foundation for Health (Funsalud), Astra Vision and the fund Complexity Capital. And in turn, it is part of an entire digital health strategy that includes the application of Acute Infarction aimed at doctors, he indicated Santiago March, director of new technologies of Funsalud.

Asked about the challenge of making this technology accessible in Mexico and for the government to invest, adopt and install it, Dr. March commented that Funsalud has a strategic area to bring new technologies that transform the health care of Mexicans and this is the first project on the application of artificial intelligence.

“Something that we are also doing, parallel to the scientific project, is the assessment of the cost-benefit of the use of this technology so that it is clear that it is an investment that will pay off in reducing expenses related to disabilities, the costs of attention or mortality ”.

Regulating digital health

In this context, the interviewees highlighted the importance of the initiative to reform the General law of health on digital health that was delivered to the president of the Health Commission of the LXV Legislature, Emmanuel Reyes Carmona. It is a proposal to reform just over 20 articles that the Legislature is already reviewing, where it is planned to organize an open parliament on the issue of digital health with the hope that it will be discussed in the rostrum hopefully in January or February 2022.

The proposal was worked on for months with a multidisciplinary team to sow and define the basic concepts of digital health such as telemedicine, software, digital recipes, among others with the participation of collegiate bodies, university faculties such as the Faculty of Medicine of UNAM, ITAM and UAM, as well as employer groups.

This proposal will be within the guidelines of international good practices such as those that already exist in Europe, related to the security of patient data, privacy and the correct use of these technologies.

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