[ycorvar]

Hi there! We are Orestis and Urs from Zeit Medical (https://www.zeitmedical.com). We enable fast stroke detection at home.

90% of strokes go untreated due to stroke recognition delays. Many patients live in fear that a stroke might happen and go unnoticed for hours, particularly if they are asleep when it starts. Stroke is currently impossible to detect based on symptoms. Unlike a heart attack, there is no distinct pain. There is a compelling need for a monitoring/alert system that will enable fast access to treatment.

Orestis has a PhD in Biotechnology and Bioengineering and has spent a decade developing wearable health-monitoring technologies. Urs is a pediatric critical care physician. Both founders have done research at Stanford. We've also both experienced the never-ending fear of another stroke in our families. We decided to do something about this problem--only 10% receiving treatment is just not cutting it!

We have a stroke detection algorithm which has been clinically proven in operating rooms. We're pairing it with commercially available brainwave sensors to create a smart headband that enables immediate stroke detection at home. The sensor pairs with our app and if a stroke is detected it alerts caregivers abs 911. This is different from other technologies that aim to improve patient transportation (once the patient is in the ambulance) or door to needle time (once the patient is in the hospital). The longest delays occur prior to calling 911, so this is the critical phase for making a difference.

The headband pairs with an app to analyze the brain’s electrical activity in real time with our stroke-detection algorithms. Brain activity metrics are already used in the clinical environment, but so far this know-how has remained siloed within the hospital. Our headband runs on AI that emulates the ability of expert neurophysiologists in digesting brain activity information to infer whether a cerebral injury is taking place.

We have recently kicked off a 15 person human factors study to assess overall system adoption and compliance. We also offer a sign up to get it first once our technology is cleared by the FDA. We look forward to your questions and comments!

[samename]

Looks amazing!

Your website also mentions seizures. Are you trying to get FDA clearance for both?

Also, why did you choose the subscription route?

[dhr]

Very interesting!

Is there some data on the 'optimal' time from when a stroke starts where intervention would prevent serious impairment? i.e. if you detect a stroke, how many minutes/hours do you have before irreversible damage is caused?

Relatedly, what measures are done when a stroke is detected to minimize damage/impairment?

Also, what's your false positive rate?

Wish you all the best of luck! I've had family members who've had strokes and early detection might have helped them a ton.

[ycorvar]

Thank you for the insightful comments and questions!

1) There is a ton of interesting research on the topic of what happens from the onset of the stroke until permanent lesion formation.

In brief, there is usually a stroke "core" where the damage starts within seconds to minutes.

However there is a big volume surrounding the core, usually referred to as "penumbra" that is of substantial size and remains "live" longer due to access to collateral blood flow. This practically means that the small arteries which run in parallel to the main one that was blocked (causing the stroke) can sustain the surrounding tissue for a longer period of time than the core. However this blood flow is not enough to sustain those tissues in perpetuity and as a result the penumbra will also "die" if no treatment is provided promptly to re-establish flow in the "main" artery.

So there is a real race to save the penumbra!! (https://en.wikipedia.org/wiki/Penumbra_(medicine))

Summarizing the above -> Time=Brain.

The most important point to keep in mind is that for treatment to be provided there must be something "left" to save upon arrival at the hospital. This is usually not the case when people get strokes during sleep or when they are alone (it's hard to detect so there is a ton of delays pre-911)

2) The management of a stroke depends on the stroke type, location, severity, symptoms. For ischemic strokes (85% of all strokes) the strategy is to bring the patient as quickly to the hospital, complete imaging diagnosis and re-establish blood flow in the affected vessel (via thrombolysis or thrombectomy)

These options are really well explained here: https://www.nhs.uk/conditions/stroke/treatment/

3) We are optimizing our tools for zero false positives. Final product requirements will be set in communication with the FDA.

4) If you think that you family members might be interested in our technology, ping them to check out our website.

[Rastonbury]

Is there anyway to put this technology on my wrist on into a t-shirt, or even implant? I like the idea I have higher risk factors for stroke, but I'm not too keen on wearing a headband nightly.

[ycorvar]

Thank you for the comment!

We have a vision to make future versions of our technology that will be even more inconspicuous. We also have IP on implantable versions of this. For people that live with stroke risk, our current form factor is the first step towards providing some peace of mind :)

[gtirloni]

I know nothing about strokes and who's at risk. Perhaps the website could be improved in that regard because, after reading it, I have no idea if I should buy it for myself or family.

[ycorvar]

Thank you for pointing this out. We are working on a "educate yourself about stroke" page that we will add in our website.

In the meantime: There are some great resources at

1) cdc : https://www.cdc.gov/stroke/facts.htm 2) aha :https://www.stroke.org/

[ano88888]

This is a valuable product and will help lots of people. I am interested in becoming a distributor/reseller in my country. I sent an email to you guys.

[dr_]

Congrats on your launch. Question, if the device is suggesting the user may be developing a stroke - what do they do? Do they go to the ER and show the docs that there’s abnormal electrical activity so imaging of the brain must be done? Without physical symptoms, I’m not sure most ERs would be prepared to deal with this…or would they? Or is it assumed symptoms would develop by the time the patient arrives to the ER?

[ycorvar]

1) Our algos are designed to detect brain activity patterns that are associated with the onset of stroke. Detection of these patterns will send an alert to the individual, their caregivers, and 911 (can opt out).

2) The patient will present to the ED, via medical transport or in special circumstances private transport. We will perform informative sessions with the EDs that lie within our initial rollout area. The EDs will know what to expect and will perform imaging on patients arriving with our alert. Going forward, the individual will also have information on their app they will be able to show the physician, to inform them with data about our tech.

3) Most commonly symptoms develop within minutes, after the neurons are no longer receiving oxygen. In an ideal scenario treatment could be provided in the patient’s home right after the alert, but before this can happen the tech will need to have gone through additional confirmation. We are currently relying on confirmation of the stroke in the ED with the current gold standard: CT perfusion or MRI.

[WORMS_EAT_WORMS]

Super neat…

- How common are strokes generally?

Seems like a lot to wear this all the time — but also I’m not familiar with the risk factor.

- How much quicker is this at detecting a stroke versus someone simply observing it happening with a naked eye?

Like how much time does this save over simply seeing physical symptoms with your naked eye or feeling the symptoms for yourself? 1 second, 1 hour, 5 hours, days?

[ycorvar]

Hi WORMS_EAT_WORMS

Great questions!

1) For the US-> There are approximately 1 million strokes every year. Stroke is the #1 cause of disability

2) Good point. We are starting with a system that can be work at night time + whenever the users feel most vulnerable. There are many patients who who through periods of increased risk (i.e. after a 1st stroke, after a transient ischemic attack).

3)Stroke recognition is one of the biggest pain points in bringing stroke victims to treatment. Strokes that happen during sleep (commonly referred to also as wake up strokes) are practically impossible to detect based on symptoms. There is not pain associated with it (like in a heart attack).

4) We have heard crazy stories from patients and caregivers about how different their outcome would have been had they been alerted a couple of hours earlier. Our vision is to help everyone go to the hospital in under 1h. Our first target is to enable everyone to go to the hospital within 4h which is currently the time window for tpa d (clot busting medication). What's the current status? -> only 4% nationwide get tpa because they arrive too late.

If you know when the stroke started and its more than 5h past that -> no tpa.

If you don't know when the stroke started -> no tpa.

[lharries]

This looks fantastic! I’d love to know what are the signals and models you’re using to detect strokes? (any papers you could link to would be awesome) And what’s the accuracy like?

Also, are you thinking you’ll try and sell into hospitals or purely D2C?

[ycorvar]

Thank you for the comment !!

We cannot share our models but we are using brain wave analysis to detect stroke. Our algorithm is currently tuned for maximal specificity and might be tuned differently for inpatient and outpatient use. We are in conversation with several EEG vendors for inpatient use of our algorithms.

[jranieri]

Best of luck to Orestis & co, they have been investigating this domain for many years and they are in a great position to find the product-market fit.

[ycorvar]

Thank you!

[agustif]

Could this be used outside of the US? Like in Mexico

Would it be useful for someone who had small lacunar strokes which provoked parkinson?

Thanks, awesome company

[ycorvar]

Thank you for your comments!

1) Currently focusing on clearing the FDA in the US. One of our clinical advisors is very passionate about helping bring this also to Mexico. Please sign up in our waitlist and we will make sure to keep you posted.

2) You are raising a very good point about lacunar strokes. In general these are deeper in the brain structures and not easily picked by cortical-level brain activity monitoring. However we feel confident that once our product is regulatory cleared and out there collecting data, we will be able to pick the finer effects caused by such strokes.

[Mizza]

Would love it if you could detect hemorrhagic vs ischemic so people at risk could keep tPA at home!

[jitl]

How do outcomes for stroke patients vary based on treatment?

[ycorvar]

Time to treatment is the most important factor in defining stroke treatment outcomes. Stroke outcomes are quantified at 90d post event with a metric called Modified Rankin Scale. The treatment strategy is defined based on the type, location, and severity. The two options we have for ischemic strokes (i.e.85% of all strokes) are TPA (clotbusting medication) and thrombectomy (catheter based mechanical removal of the clot). Each of the them has its advantages and disadvantages but the common denominator is that the earlier the patient arrives in the hospital, the more efficacious they are.

[jitl]

I think you should further synthesize and emphasize these facts in your marketing - otherwise, the impact and importance of your work isn't apparent to laypeople.

[ycorvar]

Thank you for this insight. Communicating accurately the value is a very important aspect in what we are building.