Telephone voice analysis detects atrial fibrillation

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Atrial fibrillation (A-fib) is an abnormal heart rhythm that increases the risk of stroke five times and triples the risk of heart disease. A-fib can also lead to complications such as kidney failure and dementia.

Globally, one in four people over the age of 65 will develop A-fib, prompting calls to screen everyone from their mid-60s. Currently, screening is very limited and is usually done with an electrocardiogram (ECG).

However, although A-fib is treatable, it is often asymptomatic and can be difficult to spot on an ECG reading — like finding a needle in a haystack, says James Amihood, CEO of Cardiokol.

James Amihood, CEO of Cardiokol. Photo courtesy of Cardiokol

“The mother of one of our founders had a stroke from A-fib and he couldn’t believe the ability to detect was so low – less than 10%,” says Amihood, speaking to to ISRAEL21c of the company of five years. headquarters in the airport city of Israel.

“He realized that there is an unmet need for a cost-effective way to monitor elderly patients more frequently. And it must be suitable for the elderly, because the elderly do not like clothes.

Voice analysis was the answer that the founders of Cardiokol found (collar is Hebrew for “voice”).

“What’s easier than talking?” Amihood points out.

Launched a few months ago, Cardiokol’s software extracts and identifies voice parameters associated with an irregular heartbeat.

Embedded in applications for telehealth providers, HMOs, or health insurers, the software uses signal processing and artificial intelligence to detect A-fib’s vocal biomarkers simply by listening to the person say “aah” for a few seconds during a twice-daily phone call or while chatting with a digital voice assistant.

The patented technology works with any voice user interface such as a landline, smartphone or smart speaker.

The technology does not raise privacy concerns, as Cardiokol only analyzes anonymous voice recordings and “raises a flag if that person is suspected of having A-fib,” Amihood explains. “We are not diagnostic, we are complementary.”

Available on prescription

With regulatory approval for use in Europe and Israel so far, Cardiokol’s software is available by prescription in Israel. Additional commercial agreements with pharmaceutical companies are in progress.

The company has conducted clinical trials involving 700 patients and will soon begin further trials in Europe and later in the United States. Investors include Bayer and its G4A partnership program, and insurer AXA.

A private company, Cardiokol has some heavyweight talent behind it.

The founders – Alon Goren, Yirmi Hauptman, Eli Attar and Pini Sabach – all have decades of experience in technology and entrepreneurship. They identified early vocal biomarker research and developed their unique technology in-house with industry consultants.

“We do a mix of telecommunications and telehealth, so we have people from both sectors,” says Amihood.

The society’s advisory board includes, among others, Professor Natan Bornstein, former vice president of the World Stroke Association and head of the stroke unit at Shaare Zedek Medical Center in Jerusalem; and medical physicist Amir Beker, founder and president of Biological Signal Processing (BSB) in the field of ECG.

“Our proprietary algorithms are based on neural network models that have been established with our growing clinical database of voice recordings of atrial fibrillation and normal heart rhythm with corresponding patient ECG recordings,” says Amihood.

The Cardiocol team. Photo courtesy of Cardiokol

Now entering a Series A funding round, the 15-employee company has won several competitions. In June, Cardiokol was one of three Israeli startups to win prizes in the international Oracle Startup Idol competition, cited for having “the most innovative solution”.

Sky is the limit

The second iteration of Cardiokol’s technology, currently in the proof-of-concept stage, will extract voice biomarkers from a normal telephone conversation, rather than the patient’s “aah.”

It will monitor whenever someone is on the phone, and if an A-fib episode occurs during the call, the app will detect it.

Image courtesy of Cardiokol

Amihood says no other company remotely monitors A-fib using voice analytics.

“Timely detection and management of arrhythmias such as fib A can prevent more than 70% of associated strokes and other costly chronic complications,” he said.

A-fib is just the first use case for this low-cost telehealth solution.

“We can find additional cardiac indications the same way,” says Amihood. “The vision is that just by speaking, we will be able to detect multiple indications.”

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