A traditional symphony may be performed by brass, woodwinds, percussion and strings, but one scientist believes she’s found another unlikely instrument: heartbeats.
And this could help doctors diagnose heart rhythm problems in patients.
Elaine Chew, a pianist and professor of digital media at Queen Mary University of London, is analysing heartbeat patterns in patients with rhythm disorders — called arrhythmias — and turning them into pieces of classical music.
Elaine Chew, a pianist and professor of digital media at Queen Mary University of London, is analysing heartbeat patterns in patients with rhythm disorders — called arrhythmias — and turning them into pieces of classical music
She believes once heartbeats are presented in a musical score, it is easier to find trends and this, in turn, could help doctors recognise subtypes of arrhythmia more accurately, leading to more effective treatment.
Arrhythmia affects around two million people in the UK. There are many types, but, in general, it is caused by faulty signalling in the heart. Often, there are no symptoms, but it can lead to tiredness and breathlessness and raises the risk of heart attack or stroke.
The most common form is atrial fibrillation, where the heartbeat is irregular and abnormally fast, due to electrical ‘short circuits’ in the heart muscle. This raises the risk of stroke, as blood can pool in the heart’s upper chambers and form clots. Long-term, patients are at risk of heart failure — where the heart stops pumping efficiently.
It was while undergoing a procedure to treat her own atrial fibrillation last year, aged 46, that Professor Chew really noticed the significance of heartbeat rhythm.
‘I had a different heart rhythm disorder, tachycardia, years before and, this time, it felt and sounded different,’ she says. ‘Unlike the fast, regular beating of tachycardia, atrial fibrillation was unpredictable and irregular.’
During the four-hour ablation procedure (where a wire is used to burn tissue that’s responsible for erratic signals), she recalls: ‘I had lots of time to think. I analyse music using computers for a living, so I was thinking of the data the doctors gathered about my heart rhythms and whether I could do anything with it.’
She believes once heartbeats are presented in a musical score, it is easier to find trends and this, in turn, could help doctors recognise subtypes of arrhythmia more accurately, leading to more effective treatment
Doctors get a detailed picture of the electrical activity in a patient’s heart with electrocardiograms (ECGs), which capture the electrical changes flickering through the heart as a series of wave-like traces.
To Professor Chew, these were not dissimilar to music patterns. She asked her cardiologist, Professor Pier Lambiase at University College London, if she could have anonymised ECG data from patients at his arrhythmia clinic for a new research project.
‘Her idea was very interesting,’ says Professor Lambiase.
‘When we look at the ECG, we look at this printout on a piece of paper, but Elaine thinks about intervals in a different way, so she started to think about musical pulses and how the information can be represented rhythmically.’
She then developed a computer program that converts the peaks in ECG readings into ‘notes’. It analyses rhythm changes, as well as the duration of beats and silences, to create a musical sequence.
Professor Chew says: ‘When doctors look at ECG data, they just look at the shape of the traces — whether it’s wiggly, flat, fat or skinny, and whether the pattern is regular. This doesn’t tell you how things progress over time’
‘I found the tango rhythm emerging a few times in atrial fibrillation — it goes ONE-two-three, ONE-two-three, ONE-two,’ says Professor Chew.
‘Then there is a pattern in ventricular tachycardia that is reminiscent of the main rhythmic figure in Mars from Holst’s The Planets suite. One disorder reminded me of a Bach flute sonata, while another mirrored a melody in a piece by Chopin.’
But this is more than an artistic endeavour: Professor Chew hopes her approach will improve treatment. ‘There are different types of arrhythmia, and we define them according to whether they are regular or irregular, fast or slow, and where they come from in the heart,’ says Professor Lambiase, who is working with Professor Chew to develop the program to analyse ECG patterns.
The idea is that converting the data into musical rhythms will make the underlying patterns stand out more clearly, so doctors can spot arrhythmias more easily.
‘These musical patterns in rhythm can tell you extra information about the condition of the heart, how much scar tissue there is and whether the arrhythmia is going to be more difficult to treat,’ says Professor Lambiase. He adds that this information could enable doctors to personalise treatment.
Another idea is to use the technique to reveal how heart rhythms change over time.
Professor Chew says: ‘When doctors look at ECG data, they just look at the shape of the traces — whether it’s wiggly, flat, fat or skinny, and whether the pattern is regular. This doesn’t tell you how things progress over time.
‘As someone who has lived with arrhythmia for most of my life, the time-based information is extremely important, but it’s not used. Just as musical pieces have sections like the movements of a concerto, arrhythmias are often episodic with variations within them. We need to look at the whole performance of the heart.’