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Natalia Trayanova on Virtual Hearts that Save Lives


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Natalia Trayanova on Virtual Hearts that Save Lives

Interview Compiled by Rachel Butch
 Natalia Trayanova on Virtual Hearts that Save Lives

Natalia Trayanova is a professor of biomedical engineering and medicine. Her lab creates predictive  computer simulations to generate personalized virtual hearts of patients that have life-threatening arrhythmias. These first-of-their-kind virtual hearts are already being used in the clinic to assess patient risk of sudden cardiac death and to guide personalized anti-arrhythmia interventions. On April 2, 2018, Trayanova joined Reddit’s Ask Me Anything and answered questions about his research. 

In laymen’s terms, how does the simulation work?

Trayanova: We start with an MRI scan of the patient’s heart, on which scarring on the heart caused by disease is visible. Using the scan, we reconstruct a model of the patient’s heart, incorporating the scarring. The model is like a scaffolding, which we populate with “virtual cells” on the computer. These cells can have either normal function or abnormal function, depending on whether they are in the regions changed by disease. We then stress the model, by prodding it with virtual electrical stimuli to see what arrhythmias are created. These small electrical signals occur naturally and don’t typically affect healthy hearts, but can send a diseased heart into electrical turbulence. We analyze all potential arrhythmias generated by the model and devise the best way to ablate the tissue to stop them in the patient. 

I also summarized this in my Ted Talk

How do you persuade physicians to trust and use the model? 

Trayanova: For us, the first thing we had to accept was that the process of converting ideas from basic science to clinical technology is a slow process. I am at clinical meetings nonstop—I go to every one that I am invited to and I try to convey what we are doing in simple terms, which has helped me get a lot of people onboard. Once you get your partners to not just be willing to participate, but to be excited to be part of that process, they can bring it to their colleagues in other places. I’ve had a lot of success with this, and we’ve been contacted from people from other medical centers looking to work with us. Eventually, I hope a company will pick up our technology and make a usable clinical tool with our tech.

How accessible is this technology? Is this software able to run on computers that are already in use in many if not most hospitals? Does it require extraordinary processing power?

Trayanova: Right now, it runs on the super computing system on the JHU (Johns Hopkins University) campus. However, it is still a research software at this point—which is always bulkier and heavier because we need every tiny detail because we aren’t sure what we will need and what we won’t. If our approach is going to be widely implemented in the clinic, the processes will need to be streamlined and the software rewritten to cut down on a lot of the bulky information.

How would this translate to other organs, such as the brain?

Trayanova: Our virtual heart approach provides an example of how this approach can be used in other organs. However, the brain is the most complex. Building a model like the virtual heart requires a lot of knowledge about the physiology and physics of the processes taking place in the organ. I don’t think we are there yet with the brain, as we haven’t acquired the necessary information about the structure and interconnectivity of the circuits in the brain. I believe other organs may become “virtual” before the brain does.

What has your experience been like as a female engineer and researcher? Could you describe one of the biggest challenges you have faced and how you overcame it?

Trayanova: I am a very determined, goal-oriented person and I think that has helped me to ignore the negative stuff. There is sexism everywhere. Every time someone has doubted me, I told myself, “I’ll show them later.” It has worked for me so far and these negative experiences haven’t held me back.

I love working with my female students—they are real go-getters. I hope to promote strong females who are able to stand their ground and know what they want. There are definitely more female students in engineering than when I was in training, but we now have to find a way to promote this level of diversity at the faculty and leadership level as well.