Episode 99: How AI in Medicine is Transforming Arrhythmia Care – Insights from Venture Capital

Is your heart fluttering and not just from the sound of my voice in this podcast? Well, join us today when we talk about AI, arrhythmia, and innovation. You're listening to BIO from the Bayou, empowering biotech leaders with the tools, assets, and expertise to improve healthcare outcomes.

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Serving the entire Gulf South, but recorded in the heart of New Orleans. Welcome back to BIO from the Bayou. I'm your host, Dr. Elaine Hamm. I'm the executive in residence from Tulane School of Medicine, and today's guests are Rob Crumman and Dr. Travis Manesco. Rob is the CEO of Vector Medical, a biotechnology company working to revolutionize arrhythmia care through their non-invasive AI tool, VMAP. And you may recognize Travis from a previous episode where he talked to my co-host James about attracting venture capital. He is a principal at Solis Bioventures, and Vector Medical is one of their portfolio companies. So welcome to the show, Rob and Travis.

Thank you for having us, Elaine. I'm very excited to be here.

Wonderful. Well, you know, I'm going to start, Rob, with you. Hopefully. I'd love to get to know a little bit more about Vector Medical. What gaps in patient care or what workflows are you trying to address with this? And how does AI help you do this?

Well, thanks, Elaine. And I am delighted to be here. I really do appreciate the opportunity to speak with you and your audience. about Vector Medical AI in medicine.

And we're not just paying you to say that either, so.

So, just to start off, Vector Medical used AI to develop what we call the Google Map of your heart. It's a technology that's called VMAP, and it's designed to help doctors better treat patients suffering from cardiac arrhythmias. So, I think there's a little bit of background that might be helpful to—

I would— I was about to say, that was gonna be my next question. I always love to know the journey of like what inspired you to start Vector Medical, so please get into that.

Well, so let's go with what's an arrhythmia? What are we talking about? And, and I think it's important for people to understand that it's not something you read about in the news. It's not as sexy as cancer or a heart attack, but it's something much more complicated for medicine. So very simply, an arrhythmia is when the heart beats out of rhythm. It's too fast, too slow, abnormally, or irregularly, and hence the name arrhythmia. And like I said, you don't, you don't read about it that often in the news, But it's a, it's a massive challenge for modern medicine. They're both extremely common and dangerous. 1 in 4 of us will develop a serious arrhythmia in our lifetime. Arrhythmias are a leading cause of stroke and dementia, and this will probably shock a lot of your listeners, but they're the leading cause of death in the world. By some estimates, 10 to 20% of all deaths every year are caused by arrhythmias.

I'm really glad that you guys are addressing this because, not just because I turned 45 this year and I'm concerned about arrhythmias, but I love that you guys are calling more attention to this. Please go on.

Well, we appreciate the platform, and the other thing that's really important to understand is how do they form and what do we do today and where are the pain points in medicine? So, arrhythmias are typically caused by damaged heart cells. So, we have specialized physicians that are called electrophysiologists. I'll probably call them EPs. It's a lot easier to say. And they go in and they can go in with a procedure called a cardiac ablation, and they can destroy or treat those damaged cells in your heart. And the incredible thing about our body is that when that EP goes in and treats the correct cells in your heart, your heart returns to normal healthy function. So you went from a person who has a massive stroke risk or a lifetime dementia risk or a pretty scary death risk, and by simply treating those damaged cells, We can return you to normal, healthy function. But the challenge in medicine, the biggest challenge in electrophysiology, is how do we identify where the arrhythmias are coming from in a quick and accurate way so that physicians can get in, treat the problem, and get the patients back to normal living?

I've never thought about, really, my mom has had that cardiac ablation several times, and I never really thought about how do they know exactly where is that arrhythmia happening? That's such an interesting point.

You hit the nail on the head. So, in many patients, and the truth is, in a majority of patients, it's not always clear with our current tools what cells are causing the arrhythmia. So, as you mentioned, oftentimes multiple procedures are needed to get the correct area of the heart and treat it. And that's incredibly frustrating for patients. It's very difficult for doctors.

Mm-hmm.

But it also puts an enormous strain on the healthcare system. And so that's where our technology comes in. We— VMAP changes the equation. We use the most common test in cardiology, the 12-lead ECG, and we apply advanced algorithms and we're able to reveal insights that weren't previously visible. So in under a minute, our VMAP technology can identify the potential arrhythmia sources across the entire heart, all 4 chambers. And that information allows the physician to plan the procedure, the ablation, and deliver not just improved patient outcomes, but faster, safer procedures. And that's where AI is really changing medicine.

That's really great. And, you know, Travis, I'm gonna switch to you now. You come at this from both a physician standpoint as well as an investor, and I'm sure you can tell stories of being in the ER and understanding, you know, when a patient comes in, I'm sure cardiac and chest pain is one of those scary things that people come in with, but love to know what really stood out when you were evaluating this company and maybe giving your investor and your physician hat as part of your answer.

Sure.

Thanks, Elaine. I'll put both hats on. It might look a little awkward at first, but we'll, we'll get through it.

2 hats away.

We'll get through it. Yeah, 2 hats. Yes. Uh, we'll maybe have the bills going different directions. But the first thing I'll say is, you know, I, in, in the ICU, you know, where I practice now, I take care of a lot of patients that are further down the arrhythmia ladder, meaning they've had AFib and they've produced a clot in their heart, and then it has been essentially ejected into their brain and now half their brain is, you know, they underwent a stroke and, you know, had treatment for that. And so I see the devastating effects of that. And then the other is being in the ER, you know, as an emergency medicine, you know, trainee and practicing, you know, you're handed an EKG every 5 minutes. And so it's like, it's something— the EKG is foundational to medicine. It's something classic. But, you know, at Solace, we saw the unmet need immediately. We saw both from the patient and the physician perspective, which is something we like. And then they take the EKG, which, you know, as you go through medical school, it goes from something very abstract and squiggly lines on a paper to a diagnostic tool. And it's almost like Vector is the next step in the next generation where you take that, the squiggly lines that become a diagnostic tool as you learn where the different electrodes are placed. And then Vector is now turning the EKG into a GPS, or it's turning it into a non-invasive mapping procedure, which is cool, right? It's like, that's what you hope AI will do is take what we have and then make it so much better. And then, you know, the results are actionable. You talk to physicians, it doesn't impact their workflow. They're already doing an EKG before they begin their procedure. You know, it can save hospitals money. They had data on saving time in the EP lab, and physicians can do more procedures, help more people. And then I have to do this. Sorry, Rob. There's a shout out to Rob's parents. Okay. Because Rob is the CEO and the inventor is his brother. Is it older or younger, Rob?

Who's older?

He's older. The older brother is an EP doc and invented this. So, I mean, what—

Wow.

What tremendously intelligent children, and they should be proud. of what their kids are doing. But, you know, that just segues into the leadership team. We saw the leadership team. So if you will recall episode 94, The Soulless Approach to Investment.

Love the shout out.

Love the shout out.

Where we— yes, yes. And yeah, please listen to episode 94.

Yeah.

Bio from the Bayou, where we walk through the soulless approach to investment, but we have, you know, the DOAT, GOAT, FLOAT, and MOAT. And so the DOAT is, Does the treatment offer therapeutic efficacy? Check. And then the GOAT is the management team. As our managing director, David Adair, says, are they the greatest of all time or are they the fur-legged furry kind? And so you gotta figure out what GOAT, you know, you are. And so we were impressed and we saw the clear patient benefit and it just, it checked all the boxes for us.

Well, and I really like a couple of things that you said, especially as it relates to inventing things and commercializing things that are going to be adopted into clinical workflow. You have to have something. You can't just completely disrupt the way that a physician is currently doing things and expect that you're going to have an immediate commercialization success. It can be really challenging. Every I mean, people are humans, right? I mean, we we want to do things how we've always done it, and it can be challenging to do something new, even if you know the clear value proposition. And so, having something that already works very nicely into a workflow or to use this technology that the physicians and the team are very familiar with can really help sort of just. easily plug and chug, as we've said, and into a process that makes it a little bit more manageable from a value proposition too. It can just be— I've gone down that path of just, you know, it's— this is great, but you're asking the physician to do something completely different, and it's not going to fit from a workflow. It's not going to be, you know, reimbursed from an insurance perspective. And so it just can be really challenging, and it sounds like this kind of fits nicely in. And when you see AI and you see, you know, data opportunities, it can— it's hard to stand out from a crowd. There's just so much out there in terms of pitches and decks that have slapped AI into their deck and said, you know, we're an AI-driven company. How do you pick out from the noise, Travis, as you see things like that?

One thing I want to say about your earlier point, too, is, yes, about going into the workflow. Does it impact the physician's workflow? But also, You know, does it impact— maybe it doesn't impact the physician's workflow, but it gives the nurse or the pharmacist 2 more hours of different work, you know? And so you have to have all these, you know, in the hospital, there's all these different stakeholders. It just depends where you are. And so you do have to neatly, you know, when you have a cath lab, you have a lot of different people, the nurses, the— you have sometimes you have CRNAs. And so it really has to fit seamlessly. So I just, you know, I agree with the first point.

That's great. That ecosystem is important to consider.

Yes, exactly. And then the second question, AI.

So, AI, yes. How do you, how do you stand out? I'm sure you get a ton of decks, period. But then I'm sure on top of that is the new sexy thing, AI, and people just putting it on there as AI-driven. Like, how do you stand out as an AI company from the, the posers, I guess?

Well, the thing about venture investing too is I'm gonna, this is gonna caveat anything I say from now and forever, is that I won't know if I'm a good investor for 10 years. You know, we don't know if the investment we make is going to be meaningful for 5 to 10 years. That's a venture timeline. But the way I see it, you know, with that caveat aside, is it has to hit an unmet need. And then, you know, it's not AI for the— that's what we always say. It's not AI for the sake of AI.

Yeah.

And so are you actually solving a problem? Are you actually going to impact a field? What are all the downstream consequences we just talked about in terms of, are you going to You know, maybe you make one team member's job easier, but you've added a lot more complexity to a lot of other team members. So that's not really gonna get a lot of, uh, uh, buy-in. And have you built something that physicians want to use? And to be honest, you know, if you look at VMAP, it's something I would want, you know, if I were a patient.

Yeah.

You know, and so, uh, you can kind of put both hats on. We have a lot of hats on now, but you can kind of look at it from both of those perspectives. So I think those are A few ways to stand out. I'm trying to think if there are any. I can't think of any more.

No, those are great. Those are fantastic. And one of the things that struck me when, Rob, when you were talking is that I immediately knew that problem myself. I, I could see my mom having to go through multiple ablations and them not getting it right. And, and there was just this like, oh yes, that makes total sense that this is something that would be useful. And so that simplicity of that, oh yeah, that aha moment is also really helpful. And, and Rob, you know, Speaking of Vector Medical, what is the most exciting thing that you think is coming out of the company besides the patient impact? Because I think that's very clear, but what, what are, what gets you most excited right now?

Yeah, it's a great question. And I think the conversation's been really fantastic so far. I, I have to start with patient impact, and I, I know you asked me not to, but one of the things that we do in our company is, is we're, we are part of the procedure. We help the physicians prepare for the procedure. We, help guide them through the procedure. And we get reports at the end of each procedure. And I actually get a copy of every single one of those reports and they come on my desk and I read them every night. And it's becoming a much bigger burden these days. I have, you know, tens and dozens of procedure reports to read, but it's that patient impact that matters so much that drives us to work so hard. You know, you do hear the stories of the patients who've had arrhythmias for years. They've had multiple failed treatments. They're living A life that isn't what they envisioned. They wanted to retire and play golf. They wanted to retire and scuba dive, and they're having trouble getting off the couch. They're really out of options. And so when an EP uses our technology and they can directly target the sources of the arrhythmia, it's life-changing. That's something that I'm most excited about. But from a technology perspective, we're really excited. We talked about this a little bit ago. It's about working within the physician workflow and fitting seamlessly into the lab. And there's a lot of new technologies coming out in electrophysiology, which are super exciting. It's worth a whole podcast for you guys to talk about. It's a new energy source. It's safer, it's faster. It's almost like ablation for dummies. You know, even the guy that finished last in medical school can, or gal, can apply PFA in a way that's safe and effective. And that's super exciting. That, that's democratizing this procedure, which is wonderful. But then you add that new energy source, plus a guidance on where to treat, and you've really done something that's intentional and exciting. The other thing that we do, because we're in at the procedures and we collect data throughout the procedure, is that we, we're building a really powerful dataset. And that's important in the AI atmosphere because our algorithms can improve over time. There are cases that we'll go to, you know, I'm delighted we've had clinical studies that show improvements from 50% in clinical efficacy up to into the mid-80s, 86%, which is phenomenal. But that means there's 10% that I don't have an answer to. And the exciting thing about more data is that I can look at that case and I can train my algorithms on those ones that I don't have answers for. So the next time I see that case, I do have an answer for that patient. So it's a lot to be excited about. And at the end of the day, it comes back to helping patients, but it's really about thinking about the patient, thinking about their family. How did you impact that family when you got them better, getting them in and out of the hospital? And so that's what we do, and that's why we do it.

Well, and I like the democratization piece that you mentioned because, I mean, it— one thing that I have really appreciated about AI is being able to deliver better care in places that may not have the, the world's best cardiologist right there in, in their hospital system. And, or there, you know, I live in, you know, rural area and we get cardiologists that come down from the city, you know, and that is something that can be really challenging for a broad piece of America being able to access experts. And so having a map of a heart is something that can be given to anybody within the healthcare system. And I think that's really, you know, what AI is meant to help in terms of healthcare. So that's really exciting.

I'm so happy you mentioned that because we literally have Physicians at rural hospitals who are no longer sending their patient to the— they literally have to send their patient to the quote unquote big city to treat them. And they're now staying in their home hospital. They don't have to drive 3 or 4 hours to get in the care they need. Because often those patients don't actually get their care. They're working hard, they have a job, but if they can see their doctor that they know and trust, and that doctor can now handle their case. It makes a big difference.

That's fantastic. Well, I could see Ian's telling me a little bit to wrap it up. I could see his face. So I'm going to ask you guys, now that you both have had experience on the venture funding side, on different sides of the table, reflecting on your experience, what do you think founders should focus on most when pitching their new AI and medicine technology to a VC? And Rob, I'm going to start with you.

Well, I think first of all, it's, it's important to show clinical value and not just theoretical value. You have to demonstrate your innovation is real and has positive impacts on patient outcomes. That's what we've been talking about. But I want to really go back to what we talked about earlier, which is understanding the importance of workflow. And so when you're talking to a VC, you need to explain that you know how your technology is going to fit into what the physicians are doing and what they're doing and what they'll actually adopt, because if a doctor isn't going to take on your technology, no matter how cool it is, if they're not going to add an hour to an already 3-hour procedure, then it really doesn't matter how strong your science is. One of the neat things Travis mentioned, my brother is one of the inventors of the technology. He's an electrophysiologist. He knew his pain points. And so he was able to design the technology to work in a workflow that he would be happy to use it in. And so that really helps us We have an incredible medical advisory board. They help further tweak those things, but you have to work with the tools that doctors use. And I think that's a big reason why VMAP resonates with doctors and also with investors like Travis and his team.

All right. And Travis, I'll throw that question to you as well.

First off, Rob's exactly right. And these are classic investments we really like at, at Solace. There's some inventor, who's a physician, not, doesn't always have to be a physician, but somebody that intimately knows their area, knows the pain points, and then identifies a way to fix those because it is very clear when you're getting pitches about when you, especially in the AI realm of people that have this AI technology, but don't understand the healthcare system versus people that truly understand how the healthcare system works. I still think we need people that, you know, are coming from outside other areas. All innovation could benefit from other lenses, but it's really beneficial to have somebody that understands that. So, but just to add a couple more things, clarify the unmet need or clarify what you're trying to do and that you understand from a patient hitting the door in the hospital or a patient hitting the door in the clinic to when they receive, you know, whatever care they're going to have or whatever tool you have. And then it has to be an exponential value win. You know, a lot of things you see are incremental and there's a cliché about it. It's just a fancier mousetrap and they got great mousetraps out there. That doesn't mean we shouldn't keep improving the mousetraps, but that is not something venture investors are interested in. We're looking for whole new areas, whole new technologies that will build new verticals in the healthcare system. And so the other thing I'll say, and this happened to me too, so Just be focused. And so when I heard about VMAP, I was like, oh, well, you could do, you know, I'm an ER doctor, right? Well, you could have it in every ER, right? Like, where are all the places a patient has an EKG? A lot. I mean, there's a lot of places somebody has an EKG. And Rob and his team have been very tactical about, okay, this is where we're gonna go. Yes, we could go all these different places, but we have to be focused and make sure there's buy-in and make sure our customers and the patients are taken care of. And I always tell people that Amazon started with books. You know, so you start with books.

Absolutely.

And then you can slowly land and expand. And then maybe you have, you know, VMAP trucks everywhere in 20 years. So just like Amazon, who knows? But the only other 2 things I'll say is the reimbursement strategy. I mean, that is, you really have to have a very well-thought-out reimbursement strategy from the beginning. Because if you're, and, uh, you know, like Rob said, if you're adding time and you're adding costs, Well, you've already added 2 things the healthcare system doesn't need. So, you know, you've added burden to overburden healthcare team members, and then you've added cost to, I mean, we've all seen the graphs. And then the last thing I'll say is, you know, build a business and not a science project. And so show you understand both the science and the financial aspect of it.

That's fantastic. And I also really love, we talked a lot about ecosystem around the technology and talking about the doctor's sort of journey, but I really like that you brought in the patient's journey and putting yourself in the sort of end user, I guess, in a lot of ways, what they go through from the moment they walk in with a complaint to the end where they're hopefully successfully treated. And that's why we're all in this, right, is that we can hopefully successfully treat patients. Well, thank you so much for talking with us, and we'll be sure to keep an eye on Vector Medical. And of course, Solis Bioventures is now a friend of the pod, Travis.

Yeah.

I'm calling it right now, friend of the pod. Well, I'm sure we'll bring you back again.

So yeah, I'm fist bumping. I'll put it in the show notes.

I'll make sure.

It's like, this is not a visual show, but I'm just going to tell you that Travis is definitely fist pumping. I guess we used to call that the Arsenial Hall, you know, I just showed my age. Stop, stop now, Ham. All right, well, guys, thank you so much. And as always, we will have Rob and Travis's contact information as well as informational links posted in our show notes. Be sure to check them out to learn more about Solis Bioventures as well as Vector Medical. Thank you once again for joining us, guys.

Thank you. Thank you so much.

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