Developing cardiac digital twin technology

The King’s MedTech Accelerator is a six-month programme that supports aspiring entrepreneurs from across King’s Health Partners to transform research innovations into viable healthcare ventures. Accepted onto the programme from King's Health Partners, Dr Martin Bishop is delivering one of the 26 projects from the 2025 cohort. KHP News met with the project lead to find out more about their Cardiac Digital Twin Technology study.  

Can you tell us a little about your background and role?

I make computer models of hearts with Digital Twins for Healthcare - a part of the School of Biomedical Engineering and Imaging Sciences at King’s College London. To make these models you need to understand the computer science, the physics, and the maths of the heart. The heart has three different physics actions to it, there's the electrical side, the mechanical side, and the fluid side. I work on the electrical side, trying to understand things like cardiac arrhythmias, why they occur, how they occur, and how we can treat them. For me, cardiac modelling is the definition of interdisciplinary science. 

What is ventricular tachycardia? 

Ventricular tachycardia is a type of arrhythmia that happens when the heart stops pumping blood around the body as efficiently as it normally would. It can cause palpitations, lethargy, and some people can collapse because they don’t get as much blood as they need to the brain.

There are three keys to understanding what causes ventricular tachycardia:  

• Genetic and congenital conditions can put people at risk. 
• Hearts can deteriorate due to sickness or diet, leading to blocked arteries and scarring of the heart. 
• Certain drugs can cause hearts to behave differently.  

How is ventricular tachycardia treated? 

One way of treating ventricular tachycardia is with defibrillator devices, but it can be difficult to decide who needs these devices. Deciding not to implant a device can be fatal if a patient has a lethal episode of an arrhythmia. However, implanting devices can also go wrong when patients undergo costly operations that put them at risk of infections, with devices that can go off inappropriately. We only want to give devices to people who absolutely need them, so we’re developing heart models to make that decision process easier. 

Another way of treating the condition is with an ablation procedure which is an acute treatment. This procedure is for patients suffering with recurring arrhythmias. Before the procedure, a catheter with electrodes is used to identify the precise area of the heart where the ablation needs to take place. However, it can be difficult to interpret the catheter recordings and to know where the right part of the heart is to carry out the ablation procedure. By creating a digital twin model of a patient’s heart, we can try to simulate what's going on, giving the doctor a 3-dimensional model before they go into the procedure, so they can find where they need to go. The idea is to make the procedure easier for clinicians, safer for the patients, and hopefully faster and more effective for everyone.  

Does digital twin modelling work? 

Digital twin modelling is the practice of creating virtual models of real-world objects. In the field of health and life sciences it has a lot of power, not just in terms of what I do with the ablation procedure, but for lung issues, liver problems, and other areas of cardiac health. It can give clinicians the ability to study and understand a patient’s organs before they have to perform any kind of procedure. 

However, there is still work to do to get people on side. Most people will happily sit on an aeroplane without a thought that not only is a computer flying the aeroplane, but the computer helped design it and all its safety features. But people can feel a bit funny if you tell them a computer's going to be used to guide their heart procedure as well. 

How are you getting patients on board with digital twin technology?

The patient and public involvement (PPIE) work I've done so far has really opened my eyes. We had a comment from one patient that I wouldn’t have thought twice about before. They said there may be a case of too much information for some patients and that showing them a model of their heart before a procedure could completely freak them out. Before those sessions I never would have thought that would be the case. I thought surely people would love to see computer models of their own hearts. It's little things like that that makes you realise the reality. It's easy to sit behind your computer just thinking about the science, but if we're putting technology into patient spaces, we need to think about how they would interact with it as well. 

What are your hopes for the future of digital twin technology for cardiac health?

I want to see it used. I wouldn't be sat here as an academic if I was motivated by money because I would be two miles down the road in the city using the same skills to work in a bank. But I really believe in what we do. I'm hoping that our approach will stand the test of time. It's about making a difference and trying to take what we've made into the clinic.  

The past year or so has been pivotal in terms of what we have been able to achieve. I've been convinced by our own data that it's going to work, so I've been a lot more excited and motivated to take that next step. But taking that next step requires more funding because it's one thing to make a model, it's another thing to put it into a clinic and show that it works.  

How has working in partnership enabled this work? 

Personally, it has helped me a lot. I received funding through KHP Pump Priming Awards which have been invaluable. Grant writing is hard, and it can be tough to get funding, but the way to make your grants better is to have a year of dedicated time to gather data. These awards can help when you believe in the value of project, but don't have the data you need to convince someone to award a huge amount of money. It gives you the opportunity to spend a year gathering data with a small amount of money. That's exactly what we've done this past year with the ablation digital twin technology. 

King’s Health Partners has also expanded my network. A lot of the time, when we do clinical studies, we are limited by the number of patients we can work with. This is because the number of patients that come for ventricular tachycardia ablations in one hospital might only be 50 a year. When you work in partnership, that umbrella makes it easier to include more patients in your research. The King’s Health Partners Annual Conference and all the events also make you feel part of something that's a bigger than what you're in. It gives you an opportunity to meet people and start new collaborations. 

Since our interview with Dr Martin Bishop, the British Heart Foundation has awarded £1.28m as a Programme Grant to take this work forward for another 5 years.