Dr Will Nicolson

WBNConsultant Cardiologist / Honorary Senior Lecturer

Personal details

Research Fellowship: Implantable cardioverter defibrillators – Improving risk stratification

Awards and grants

  • 2011 Young Investigator Award Clinical Prize, Heart Rhythm Annual Congress
  • 2011 Medical Futures Award - Best Innovation in Cardiovascular Diagnostics - A Medical Futures Innovation Award is one of Europe’s most prestigious healthcare and business accolades, rewarding innovative ideas from front line clinicians, scientists and entrepreneurs. Winning this award has given me and the LifeMapTM team an invaluable opportunity to attract interest and investment. This endorsement by a world-class panel of experts in addition to the Young Investigator Award and EMESP Master's Prize creates a broad platform of support for the innovation.
  • 2011 EMESP Masters Prize
  • 2011 Young Research Worker Prize, CardioRhythm
  • 2010 and 2011 National Institute for Health Research BRU Research Fellowship
  • 2010 Da Vinci Clinical Impact Award - This was awarded for the promise shown by the R2I2 proof of concept study. The prize included creation of a promotional video available to view online at the link below and led to a BBC news feature showcasing the work.

Research

  • Action potential duration restitution and its role in the genesis of ventricular arrhythmi
  • Cardiac imaging of myocardial scar: identifying anatomical features that have the potential to act as ventricular arrhythmia foci

Three million people die annually of sudden cardiac death - 100,000 in the UK alone. Sudden cardiac death can occur without warning. It is caused when the heart flips from a normal steady heart rhythm into a lethal irregular heart rhythm.  These deaths could be prevented with a device called an implantable cardioverter defibrillator (ICD).

This is a small metal device a bit like a pacemaker and can be inserted in a minor operation. The ICD constantly watches for lethal heart rhythms. If it sees one it can deliver treatment within seconds to restore a normal steady rhythm.

ICDs work very well but they are expensive and there carry risks of complications. We know that some people, for example people who have had heart attacks, are at high enough risk to benefit from an ICD. But for most people we currently do not have a good way of testing if they need an ICD. This has led NICE to call for research into new risk markers.

I have been working under the supervision of Dr G. André Ng and Dr Gerry McCann, Cardiac Imaging Specialist with support from Dr Fernando Schlindwein, Senior Lecturer in Engineering on a new way of assessing risk of sudden cardiac death. The new Leicester Cardiovascular Biomedical Research Unit has been instrumental in providing funds and facilities for this work. The research creates a 'LifeMap': an electrical map of sudden cardiac death risk.

The heart works as a pump because it contracts in a very organised way. The heart is coordinated by the flow of electricity through it. Electrically abnormal bits of the heart can create ripples in the flow of electricity, a bit like a rock in a stream. These ripples can spread and cause the steady flow of electricity to degenerate into chaos. This effectively stops the heart from pumping and causes death.

Dr G. André Ng has been working for over 10 years on understanding the heart's electrics. He has shown that a property called restitution governs whether or not the ripples spread. If the heart is full of electrically abnormal areas, there is a lot of variation in restitution. The standard ECG looks at the heart's electrical activity from 12 different directions.

LifeMap uses the ECG to look for differences in restitution throughout the heart. This produces a map of the heart's electrical activity that can be used to measure the risk of sudden cardiac death.

A cardiac MRI scan can be used to look for heart attack damage and to create an anatomical map of sudden cardiac death risk.

Importantly, LifeMap's electrical map has been shown to correlate with the anatomical MRI map of the heart.  The project has been ongoing for two years and two clinical studies have been completed with results suggesting that LifeMap will be able to accurately identify which patients need ICDs.

LifeMap is a very exciting development and has won a series of awards over the last two years. The latest award is the prestigious 2011 Medical Futures Award for Best Innovation in Cardiovascular Diagnostics. The University of Leicester has patented the technology behind 'LifeMap'. A further clinical 160 patient trial is recruiting which will be key to confirming that LifeMap works.

The team is already looking towards collaboration with Industry on a clinical version of the device.  There many challenges ahead, but the LifeMap team are hopeful that LifeMap will be brought to the bedside to the benefit of our patients.

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