A new smart T-shirt embedded with sensors and supported by artificial intelligence could help identify serious heart conditions that often go undetected, according to research funded by the British Heart Foundation at Imperial College London.
Currently, people experiencing symptoms such as chest pain or dizziness are often sent home with portable ECG monitors. These devices rely on adhesive electrodes attached to the chest and connected to a monitor, which can be inconvenient to manage, particularly during everyday activities like showering.
The new approach could offer a simpler alternative. Researchers are developing a T-shirt with up to 50 sensors woven into the fabric, designed to function similarly to an ECG while being worn as normal clothing.
Unlike standard portable ECG devices, which are typically used for 24 to 48 hours, the smart T-shirt can be worn continuously for up to a week. This longer monitoring period may increase the likelihood of detecting intermittent or rare heart rhythm abnormalities.
Focus on inherited heart conditions
The project is particularly focused on identifying inherited heart rhythm disorders, including Brugada syndrome — a condition that can increase the risk of sudden cardiac death if not diagnosed and managed.
The research involves patients such as Carly Benge, a 38-year-old teacher from Watford who has been diagnosed with the condition. Because Brugada syndrome can run in families, her children are also at potential risk.
Early detection remains a challenge. Many inherited heart conditions do not show clear signs during routine hospital tests, as abnormal rhythms may not occur during short monitoring periods.
“Far too many people die from inherited heart conditions which could be treated if they were identified earlier. One of the challenges of diagnosis today is that irregular heart rhythms may not always occur during routine 10- minute hospital ECGs or even 48-hour ECG monitoring at home. We hope our AI-assisted t-shirt will provide a practical and comfortable solution, allowing us to carry out longer-term scanning that could improve diagnosis.”Professor Zachary Whinnett, who is leading the project
“By harnessing the power of AI, we hope our research can transform doctors’ abilities to spot these conditions and improve the lives of those who are unknowingly living with a genetic heart condition.”
Training AI to detect abnormal patterns
The system will rely on AI trained using data from more than 1,000 individuals, both with and without inherited heart conditions. The aim is to enable the algorithm to recognise subtle abnormalities in ECG patterns that may otherwise be missed.
As part of the study, 200 participants at Hammersmith Hospital in London will wear the T-shirt continuously for up to three months. This will help researchers assess how effectively the device can detect serious heart conditions in real-world settings.
The garment itself is designed to resemble standard sportswear and can be worn during daily activities, including sleeping and working. It can also be washed and reused, making it more practical than current monitoring devices.
Personal impact and early diagnosis
For patients and families, earlier diagnosis could make a significant difference.
Carly said: “We were celebrating at Center Parcs when we got the call to say doctors were concerned about Jodie’s ECG readings and she may have Brugada Syndrome. We knew nothing about this condition, and had no idea that actually, this could be something quite serious. It was a very emotional and upsetting time.”
She added: “Jodie had only just become a mum, and she suddenly needed surgery to have a defibrillator put inside her chest. I was really scared. It was really scary, and a very emotional time”.
Reflecting on her own diagnosis, Carly said: ”Mum just burst into tears when she found out both of her daughters had this life-threatening condition. She isn’t a crier, so it really hit me hard hearing her so upset.
“I was reassured when they told me I was at low risk of a serious medical episode, but now my concern is more for my children, and Jodie’s children, because there’s a chance of them having it too.”
She also highlighted the potential benefits of the new technology:
“You can wear this T-shirt for weeks and even put it through the wash, and then put it back on again, so it’s a lot more practical than a portable ECG.
“I got involved in this research because I want my children to have more of a chance to be diagnosed early, if they do have Brugada syndrome. If we can catch Brugada sooner and prevent sudden death, it could make me, and other parents, feel far more reassured that our children are safe.”
A broader public health challenge
Inherited heart conditions are estimated to affect around 340,000 people in the UK and are linked to approximately 12 deaths per week among people under 35. These conditions can lead to symptoms such as fainting or breathlessness, but may also remain silent until a serious event occurs.
Professor James Leiper, Director of Research at the British Heart Foundation, said:
“Too many people have been snatched away from their loved ones in an instant by inherited heart conditions. This innovative research will leverage the power of AI to help clinicians unmask these hidden conditions and identify patients at risk of sudden death.
“The British Heart Foundation is dedicated to funding groundbreaking research like Professor Whinnett’s, to help diagnose, treat and prevent sudden cardiac death, but there is still more to do. We urgently need donations to help us fund more lifesaving research to stop families losing a loved one.”
What comes next
Researchers estimate that the technology could be ready for clinical use within the next five years. While initial trials are focused on adults, the long-term goal is to adapt the approach for children and expand its use to detect other conditions, such as atrial fibrillation.
If successful, the smart T-shirt could offer a more practical way to monitor heart health over longer periods — and help identify patients who might otherwise remain undiagnosed.
