Breaking Boundaries in the EP Lab

When Theophile Mohr-Durdez was studying applied math to become a data scientist, he never expected to take that knowledge to medtech.

Then he met a cardiac electrophysiologist (EP) and embarked on an academic quest to see if it would be possible to automate clinical experience in a way that would improve outcomes for patients with atrial fibrillation.

Today, Mohr-Durdez is the CEO and co-founder at Volta Medical, a company that has developed AI software solutions to assist EPs in treating atrial fibrillation. Volta’s technology focuses on mapping abnormal regions in the heart during AF procedures and providing cues to optimize the ablation strategy. Unlike other mapping technologies, Volta takes a data-driven approach and aims to replicate the clinical experience of physicians using machine learning and AI.

Season 2, Episode 9 Transcripts

Amanda Pedersen: Determining the right ablation approach for persistent atrial fibrillation is complex, and visual electrogram-based ablation success requires a fair amount of experience and training. What if AI could match the expertise of trained electrophysiologists to analyze electrograms and identify areas of interest in real time? The founders of Volta Medical, a French startup, have developed AI software to do just that. You're listening to Let's Talk Medtech. I'm Amanda Pedersen, senior editor at MD+DI, and in the studio with me today is Theo Mohr-Durdez, CEO and co-founder at Volta Medical. So, without further ado, let’s talk medtech.

Amanda Pedersen: So, Theo, tell us a bit about Volta and the technology the company is developing to help physicians treat atrial fibrillation.

Theophile Mohr-Durdez: I co-founded this company in 2016 with three physicians, three cardiologists – cardiac electrophysiologist in fact – and we developed AI software solutions to guide cardiac electrophysiologists in the EP lab. Our first device is an AI solution that tries to detect abnormal electrograms, abnormal data during an atrial fibrillation procedure, and to basically give some very simple cues to cardiac electrophysiologists on where on where they should ablate to optimize the ablation strategy, or at least on where abnormal regions are present in the heart. So, it's basically a mapping technology OK that helps to understand where abnormal regions are during the procedure.

Amanda Pedersen: Okay, yeah. That actually answers my next question, as you were talking about it I thought to myself, ‘well this sounds like mapping technology.’ So, what sets this apart from other mapping technologies that are on the market?

Theophile Mohr-Durdez: So, the main difference is that we have a data-driven approach meaning that we are not really trying to base our technology on a mechanistic approach or on some understanding of afib, but rather we are trying to mimic clinical expertise at its best. So, we are trying to reproduce a clinical expertise that has already shown some clinical benefit for the patients, and we are trying to reproduce this using machine learning and using AI approaches. So, I think this is the big difference. And at some point, the goal will be to even go beyond human experience and to try to find ways to bring intelligence into the EP lab to optimize the ablation strategy and to optimize patient outcome.

Amanda Pedersen: Okay, cool. And I understand that you just recently completed enrollment for the TAILORED-AF clinical trial, and I just wondered if you could talk a little bit about the details of that trial in terms of number of patients enrolled, primary endpoints, and how long patients will be followed?

Theophile Mohr-Durdez: So, TAILORED-AF is a very ambitious international large scale clinical trial it is a multi-center randomized clinical trial involving 30 centers, more than 50 physicians in five countries. We have enrolled a total of 374 patients and these patients will be followed up for one year with a very stringent follow up, and we will be looking at a freedom from AF after one procedure as our primary endpoint and then we have multiple secondary endpoints on freedom from arrhythmia after one or several procedures, for instance.

Amanda Pedersen: Okay. And I imagine that helping with that is the recent financing that you guys announced earlier this year, a series B, is that correct?

Theophile Mohr-Durdez: Yes, it was a series B of €46 million led by Vensana Capital, and also involving our historical investors such as Gilde Healthcare, which is a very large medtech VC firm based in the Netherlands, as well as also Lightstone Ventures.

Amanda Pedersen: I know you can't really speak for the investors but when you're pitching to your investors, when do you kind of see the light bulb go off and the dots connect and you know that you've got them, you know that they're interested in investing in the technology?

Theophile Mohr-Durdez: If you look at afib technologies and mapping technologies in the past basically no technology has really managed to help patients beyond the current standard of care which consists of isolating the coronary veins. And if you look at the landmark trials for persistent atrial fibrillation patients and redo patients, so complex patients, you will see that results and outcomes are basically stagnating at around 50% to 60% independently of the time of the of the trial and so really the promise of our technology is that we can really breech this ceiling and reach much better outcome for patients in a very large patient population also an an underserved patient population which translates into a very large market of approximately $8 billion and also a fast growing markets that grows approximately of a 15% per year so the promise is strong we have already some promising data and we will see how it goes with TAILORED-AF, but I think that's the first component. And the second component is about the potential of AI in medicine and in cardiac electrophysiology more specifically today basically every single procedure is really a missed opportunity to learn from it and we are trying to collect data and to annotate data in a way that will help us to learn from each and every single case that each and every single procedure that is being performed and we hope that this can really lead to breakthrough technologies and breakthrough innovation and drastically help patients on the long term. So, this is really the second component I think that is a very exciting about the company and about the technologies that we develop.

Amanda Pedersen: What brought you personally to Volta Medical, were you in medtech already?

Theophile Mohr-Durdez: No, I was in university, actually.

Amanda Pedersen: Oh, okay.

Theophile Mohr-Durdez: I was specializing in applied math, I was a data scientist, and I didn’t necessarily feel I would go into medtech, I was quite interested in biology but not really particularly about medtech. So, it's really because I met one of the physicians that started Volta. And it really started as a scientific project also as an academical project to try to see if we could automate clinical expertise that had already demonstrated some clinical benefits. So, this was really the project at the beginning and soon we realized that we needed to grow an entrepreneurial project if we wanted to have the appropriate funding to go through the clinical evidence and go through the technology development stages.

Amanda Pedersen: Okay, cool. And then, a little birdie told me before the call that you have a performing arts background too?

Theophile Mohr-Durdez: Yes, as a hobby, I don't know how to really say it in English, but I do some theater. I play in theaters in Marseille every year, a play every year, it’s very exciting and very inspiring, I would say.

Amanda Pedersen: Do you have a favorite role that you've played?

Theophile Mohr-Durdez: Yes, I played a guy named Andre in theater play named … I don’t know how to translate it in English, basically it's about a group of friends that are celebrating an anniversary during World War II, and suddenly a German military man comes into the apartment and asks for two hostages. And they spend the entire dinner selecting the hostages amongst them.

Amanda Pedersen: Oh, wow.

Theophile Mohr-Durdez: So, this is a very thrilling and tense theater play.

Amanda Pedersen: Yeah, that sounds very entertaining, and I love period pieces too. I just, I was interested in asking about that because I'm a big believer in, you know, people in medtech have diverse backgrounds and all come from different, have different experiences, and I think that all feeds into what you do, you know, when you're at the company too. So, I wondered if you draw from that experience in any way as you're leading this company?

Theophile Mohr-Durdez: Yeah, it’s funny because actually even inside the company we have a lot of people who have a diverse background and also really strong hobbies and are into arts, so we have a lot of musicians among the co-founders but also amongst the entire team actually we have a lot of people that are into arts, and I do think it helps to communicate. For me, I think theater helps me to communicate, to energize the teams, probably to pitch also … I think that we should, you know, as company executives, we should try to help people nurture their hobbies and also enrich their personal backgrounds and endeavors.

Amanda Pedersen: Yeah, for sure, it helps to boost that quality of life when you know that your company is behind you and supports your outside interests as well as internal activities. So, going back to Volta, what are your next steps? Where do you go from here, now that you’ve got the financing, and you’ve completed the TAILORED-AF trial enrollment?

Theophile Mohr-Durdez: We are really excited about the next steps. So we obviously have this flagship randomized clinical trial that is going to come up early next year in 2024 but we have also of our endeavors and overall avenues that we are pursuing inside to help patients with other cardiac arrhythmias and to fulfilled into trying to see how we could continue to improve patient lives and the AI route is a long route because it's a difficult one especially in interventional medicine but I think probably it would be a rewarding one because we already see some traction and we see some very promising early results with our technologies.

Amanda Pedersen: Sure, it's kind of a risk reward thing that, you know, the low hanging fruit doesn't get you the higher reward, the bigger challenges are what lead to bigger rewards, right?

Theophile Mohr-Durdez: Exactly. And I think patience is really needed in medtech.

Amanda Pedersen: For sure.

Theophile Mohr-Durdez: The cycles are quite long so developers and data scientists are not used to such cycles but it's really rewarding when you see that you have an impact on patients when you have an impact on procedures. We have had patients that have had you know one procedure, two procedures, three procedures that were all unsuccessful and they come back for a fourth procedure without any hope, basically. … and suddenly they get rid of their AF. It’s really very rewarding for us.

Amanda Pedersen: For sure, exciting. This has been Let's Talk Medtech, and thanks again to Theo of Volta Medical for joining us today. We've got a great lineup of guests and topics for season 2 of the podcast, so make sure to rate, review, and subscribe to us on Apple Podcasts, or wherever you get your podcasts. And as always, visit us at www.mddionline.com for all your medtech news and industry insights.