Tetralogy of Fallot — a common congenital heart defect — now has its first 3D map of the heart’s electrical wiring, offering new clues about why patients often face lifelong heart rhythm issues. The research, led by University College London and the European Synchrotron Radiation Facility (ESRF), uses advanced imaging to reveal how electrical signals travel through diseased hearts, potentially reshaping surgical approaches.
Mapping the Unseen
For decades, doctors knew where the heart’s electrical pathway began but struggled to trace its course through muscle. In Tetralogy of Fallot, the right ventricle — the main chamber affected — shows a distinct pattern. Instead of the usual dense network, the wiring appears thin and scattered, like fabric draped over a surface. This discovery could help surgeons avoid damaging these fragile pathways during repairs.
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“We operate in life-or-death situations on tiny hearts. Any new insight into anatomy can improve outcomes,” says Adrian Crucean, a congenital heart surgeon in Birmingham. The study analyzed 18 human heart specimens, healthy and diseased, using a technique called HiP-CT. The method, developed at ESRF during the pandemic, produces ultra-detailed 3D scans of organs.
From Scans to Surgery
The research team created immersive 3D models and even virtual reality simulations of the heart’s wiring. These tools could train surgeons to handle complex anatomy and reduce risks of postoperative electrical disorders. Monique Jongbloed, an adult congenital cardiologist in the Netherlands, notes that many patients who had successful childhood surgeries later develop arrhythmias. “This data changes how we understand the heart’s structure and could improve their quality of life,” she says.
HiP-CT’s resolution allows doctors to see individual cells and tissues. The technique was initially used to study lungs but has since expanded to other organs. Paul Tafforeau, an ESRF scientist, explains that improvements in speed and image quality made large-scale studies possible. “We’re building a resource that lets scientists and clinicians explore human anatomy in unprecedented detail,” he says.
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The Human Organ Atlas
The study is part of the Human Organ Atlas (HOA), an open-access 3D portal created by researchers from nine institutes. The project aims to map entire organs down to cellular levels, with applications in everything from heart disease to osteoarthritis. Claire Walsh, director of the HOA Hub at UCL, highlights the collaboration’s potential: “This is team science at its best. I’m excited to see how AI uses this data to model human physiology.”
The HOA’s data is already being used to develop “digital twins” of the heart — virtual models that simulate its function and electrical activity. Vaishnavi Sabarigirivasan, a UCL PhD student and lead author of the study, says the 3D models could be printed or viewed in virtual reality. “We’ve never seen the conduction system this clearly before,” she says.
Expanding the Work
The EuReCCA consortium — a group of scientists and clinicians in London, Paris, Leiden, and Birmingham — is expanding research to other congenital heart conditions, such as “single ventricle disease.” Their goals include faster translation of findings into clinical practice, better surgical training, and open-access data for global collaboration.
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Peter Lee, a UCL mechanical engineering professor leading HOA beamtime, emphasizes the project’s interdisciplinary nature. “This data is for everyone — researchers, clinicians, and even AI developers. The future of medicine is in these detailed maps,” he says.
As the Human Organ Atlas grows, it could transform how doctors learn and treat diseases. For patients with Tetralogy of Fallot, the 3D maps may mean fewer complications and better long-term outcomes — a tangible example of how science can turn invisible structures into visible solutions.