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Hans Slijp: Continue the Dutch Heritage of the Non Invasive Electrocardiogram Technology

ECG Excellence is proud to continue the Dutch heritage of the non invasive Electrocardiogram technology which was introduced by prof. Willem Einthoven of Leiden University, back in 1911. Today this classic analogue technology is still used for initial diagnosis of cardiac disorders. Our technology addresses the ECG interpretation challenge since only 54% of 12 lead ECG’s are interpreted correct by physicians. Our mission is to re-vitalize the diagnostic and clinical potential of the non invasive low cost rapid Electrocardiogram and to save lives and reduce healthcare costs accordingly.

Tell us about yourself?

I started my career as a logistics expert after my MBA at Erasmus University Rotterdam. For 25 years i worked as partner/director for major consultancy firms such as KMPG and PA Consulting. But when i was confronted with the vulnarabilities of human live I changed course and became a CEO for a high tech startup developing a electronic cane for the blind and visual impaired.

And through this technology challenge i entered the world of pacemakers and cardiac signal processing. After the cane was introduced to the market i teamed up with my current co-founders who where already true experts with unique solutions for adressing the ECG interpretation challenge. First as a consultant and since 2018 we have been working on the concept of ECG Excellence and founded the company.

What is the inspiration behind your business?

The base technology of the classic Electrocardiogram is still the same. Electrodes on the skin measure the electrical potential differences which are generated in the heart. The recorded data is visualized in the familiar ECG graphs.

The ECG supports 2 kinds of analysis: A) the heart rhythm which tells us how many beats per minute the heart makes or the lenght of a certain phase in the activation cycle. For rhythm measurement 2 electrodes are sufficient and you can place them anywhere on your body (e.g. wrist) and in the graph you only use the horizontal axis . B) the conduction of the heart tissue. This is reflected in the ECG waveforms.

For this analysis you need 10 electrodes positioned on specific locations on the body and the data is presented in 12 graphs, each representing a different segment of the heart. The cardiologist has to analyse the patterns, convert the 2D graphs into a mental 3 Dimensional image of the current through the heart and the graphs tell him where and in which direction the electrical currents flow.

But… the heart is a floating object and the electrode are often not placed correct. Technically this implies the baseline is not stable in the graph and the direction of the current can not be determined. As a result we see the use of other diagnostic technologies (such as CT, Echo, MRI or bloodpressure) but these technologies only look at mechanical parameters and do not register the electrical performance and only register diseases which have already changed into heart rhytm problems. We have found, developed and tested software solutions which support physicians in making effective, fast, low cost and non invasive diagnsosis and detect hidden cardiac diseases just by using 12 lead ECG

What is your magic sauce?

Our unique technology can be compared to digital twin reconstruction of the heart activation, supported by AI related algorithms. We use standard 12 lead ECG device generated data and combine this with computerized models of the heart, the torso, the ECG electrode configurations and the tissue in the torso. And we have developed unique algorithms which related the ECG data to the heart anatomy.

This way we solve the ECG interpretation blockade. We offer our solutions in two categories: Basic, in which we use standard models but can immediately show if an ECG of person is normal or abnormal and Premium, in which we use 3D camera’s to make a truly patient specific diagnosis which includes ECG data corrected for electrode positions, a patient specific heart-torso model and diagnostics on disease level (shows if a person has for instance heart failure, Brugada Syndrom, and a range of ‘hidden’ conduction disorders)

Where do you see your company going in 5 years time?

In 5 years our technologies are used both by cardiologists, electrophysiologist but also on the level of general practioners. Our supportive hardware technologies make it possible to move the 12 lead ECG recording away from the clinic and the cardiologists & trained nurse. We use LED projectors to show on the torso where to place electrodes (anyone can do this) and this also enables making personalized ECG comparisons over time which today is not possible.

What has been your biggest setback so far?

The COVIID19 pandemic has hindered us in executing validation studies which we need to deliver the clinical evidence our technologies provide indeed next level disease detection. But luckely this has been a postponement and not a show stopper

What is the next big challenge for your business?

Our next big challenge is to apply Artificial Intellgence in ECG interpretation. AI related to heart rhythm is relative easy but AI based ECG waveform analysis is still a struggle since the variabilities incorporated in the base ECG technology also hinder an effective use of AI.

Our technologies adds data to the problem and an old wisedom for solving a problem is to make the problem bigger by adding more parameters. We have tried this approach already and the first results look promising

How do people get involved/buy into your vision?

We our launching our first SAAS service for ECG Interpretation early 2022. The CineECG tool provides the opportunity to test our solution (if you are a physician and an ECG interpretatoin challenge). By using the CineECG platform cardiologists, physians, investors and other professionals can reach out to us.

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