Heartfelt innovation for emergency care

Femke de Theije and her team are taking heart attack diagnosis from an hour to eight minutes.

Romy Albrecht
Published on November 6, 2023

Femke de Theije and team chose to follow their hearts and, in doing so, are helping to save the hearts of others: They developed a handheld device that reduces heart attack diagnosis from one hour down to eight minutes. 

<p>"It’s a pretty cool technology!" As she speaks those words, her posture becomes even a bit more upright. De Theije flashes a broad smile and it’s clear she's very proud of what she and her team have accomplished.You can't help but smile a little yourself – de Theije's enthusiasm is contagious.</p><p>We're in Eindhoven, the Netherlands, in the middle of the local High Tech Campus. Our goal is to learn how de Theije and team plan to revolutionize emergency care – with a handheld device that fits in the pockets of the emergency teams’ scrubs.</p>

<p>“Our device can help to determine if someone is having a heart attack, in just eight minutes and with a fingerstick of blood,” says de Theije. Traditionally, to get results that help doctors make a diagnosis you need an actual lab, a much larger blood sample collected via a venous blood draw and, well … time. It typically takes up to an hour to get the first lab results to find out if the patient who presented <a href="symptoms%20of%20a%20heart%20attack">symptoms of a heart attack</a> in the emergency department actually has one.&nbsp;</p><p><strong>One hour vs. eight minutes – this is how it compares in detail:</strong></p>

A heart attack, or myocardial infarction, happens when a part of the heart muscle doesn’t get enough blood. The more time that passes without treatment to restore blood flow, the greater the damage to the heart muscle. Some of the most common symptoms of a heart attack include: chest pain or discomfort, sometimes radiating to the arms, neck, jaw, back, or stomach, as well as shortness of breath, lightheadedness, nausea, and cold sweats. Women may experience other symptoms such as pain in the upper abdomen, nausea/vomiting, and back or jaw pain. Symptoms can vary greatly between individuals. Any unusual or persistent symptoms should be evaluated by a healthcare professional as soon as possible.

Learn more at American Heart Association
<p>The typical 1 hour process via the lab ...</p>
<p>... vs. the 8 minutes process via our handheld device</p>
<p>The usage of the handheld device that gives test results in eight minutes could relieve a lot of stress for everyone involved:&nbsp;</p><ul><li><strong>Patients</strong> don’t have to wait long for the results of their medical test and could get the right treatment faster, which increases their chances for recovery.&nbsp;</li><li><strong>Doctors&nbsp;</strong>can immediately act on the test result. In the case of a heart attack, every minute counts when it comes to limiting the damage to the heart muscle.&nbsp;</li><li><strong>The emergency care team&nbsp;</strong>can more quickly determine the people who need immediate medical attention from those who are not.&nbsp;</li><li><strong>The central lab team&nbsp;</strong>can focus on running the other medical tests that require the lab’s infrastructure and resources, while still being able to track the decentralized testing via the handheld devices in their central information system.&nbsp;</li></ul><p>The simplified testing process and accelerated turnaround time from test to result also holds the potential to help address overcrowding in emergency departments, particularly in countries like the U.S., where it's a pressing issue.</p>
<p>De Theije has always been driven by her desire to do things that can substantially make a difference in people's lives. And “Follow your heart!” has become something like her mantra. She firmly believes that if your work doesn't ignite your passion, it's time for a change.&nbsp;</p><p>And she has taken her own advice: de Theije started out studying dentistry, because she always knew that in her job, she wanted to “make something better". But after “two years and one week”, she knew that taking care of people’s teeth was not for her: “I thought this is so boring, if I have to do this for the rest of my life, I’ll be miserable.”</p>
Close up of a heart sculpture in Femke's office

"Follow your heart!

If you don’t like what you do, you must very quickly start doing something else, because your work takes a lot of energy and so you should put that in something that you really like."

- Femke de Theije

<p>“I considered biology – but that was a bit too vague for me. So it was between math, physics and chemistry. And in chemistry they had the best atmosphere, so I joined them,” she says laughing. She also loves a challenge and finding things out herself. And for that, chemistry was a perfect match: A field so broad and varied that there was plenty to discover. She ended up doing her PhD in surface chemistry because she was drawn to the creative process of unraveling complex mechanisms: “That’s fulfilling for me because in the end, you really understand something. I like putting all those little pieces together to finish the puzzle.”</p>
<p>When it comes to the technology, the team also had a puzzle to solve: Making a point-of-care device that can run a <a href="high-sensitivity%20troponin%20I%20test">high-sensitivity troponin I test</a> as well as a lab can. And that’s not easy: “Because the lab devices are getting better and better, so you have to compete with something that’s also improving constantly,” says de Theije. Traditional technologies turned out to be either too expensive to make or just not sensitive enough to measure troponin at lab quality.&nbsp;</p><p>So the team kept on searching for their missing puzzle piece. It turned out to be magnetism: "We are using magnetic nanoparticles that bind to troponin," explains de Theije. "By using magnetic forces, we draw those particles towards the surface where they can bind. The amount of bound particles on the surface is a measure for the troponin concentration in the blood sample." And this is how it works in detail:&nbsp;</p>

A high-sensitivity troponin I test is a type of blood test that is used to diagnose heart conditions, such as a heart attack. Troponin is a type of protein that is found in the heart muscle. When there is damage to the heart, such as during a heart attack, troponin is released into the bloodstream. High-sensitivity troponin tests are able to detect much smaller amounts of troponin in the blood than traditional tests. This means they can potentially detect heart damage sooner, and are also useful in ruling out a heart attack in people who have symptoms of one.

<p><strong id="isPasted">Inside Atellica VTLi – a fly-through</strong></p>
The team came up with a completely new technology that had not been available for biosensors before. “Through our, as we call it, Magnotech technology, we can be very sensitive in our troponin detection.” The eight-minute high-sensitivity troponin I test on the handheld device produces results that are, indeed, of the same quality as the one-hour lab test. “That’s so unique that some people even did not believe we could do it at first,” remembers de Theije. “… until they saw the numbers.”
Innovation seldom unfolds in front of computer screens. For de Theije and team, breakthrough moments often occur during casual conversations over lunch or coffee breaks: “You need a little bit of space in your mind,” says de Theije. “You need people talking to each other. Sometimes there are some misunderstandings and from that the bright idea is born. That's what I often see.”

And of course, the people collaborating are all experts in their fields: “We have chemists, biochemists, physicists, electrical engineers, industrial engineers, process developers and software developers in our team,” says de Theije. “And they all look at problems differently. So much that sometimes if you hear an idea from them the first time, you’re like: ‘Yeah … I really don't understand what you mean …’”. And when you bring all these different perspectives together and they start building on each other you can come to solutions that are much more sustainable than when you only looked at it from any one discipline.”
<p>With over two decades of experience in biosensors, de Theije still enjoys diving into the intricacies of technology with her colleagues. In her current job, she acts more like a catalyst for collaboration: “I love bringing everyone together to create something useful – while having fun,” she says. As head of the R&amp;D department for emergency care, her main goal is to get the device, called <a href="https://www.siemens-healthineers.com/cardiac/cardiac-systems/atellica-vtli" target="_blank">Atellica VTLi</a>, in the hands of emergency care teams worldwide: “The innovation part is actually only a tiny portion of the work we do in R&amp;D,” she explains. “In the end, it's probably not even that hard to come up with a very innovative idea. The harder part comes when you want to implement it and make your technology available.”</p><p>And that can require some patience: “These processes take time. Sometimes, you have to circle back and brainstorm fresh, creative ideas to address feedback from other teams – from the designers, the production team, from marketing and the customer support group. To launch a product successfully, you really need everyone's support.”</p>
<p>In the end, de Theije, her team, and the colleagues that support them believe in the technology and know that all the work is worth it. “We’re convinced that our solution can really make an important contribution to enable better access to fast diagnosis,” she says. “Especially also at small hospitals, in rural areas, or care institutions in low- and middle-income countries, where they don’t have a big lab nearby.” In the future, they want to develop their technology further. Since Atellica VTLi is created as a platform, it could be expanded to test for more conditions where fast results matter.&nbsp;</p><p>As long as teams like de Theije’s keep following their heart and solving the puzzles of innovation with an open-minded, curious, and responsible approach, the future of emergency care shines a little brighter.</p>

Romy Albrecht
Romy Albrecht
By Romy Albrecht
Romy Albrecht is a digital editor and multimedia content creator at Siemens Healthineers, specializing in technology and innovation topics.