An innovation from Bulgaria will save lives - Bulgarian Development Bank

The Bulgarian Development Bank (BDB) features the project in its section on successful projects. Below we summarise what the piece reports, then describe how the recording works and where the limits of the method lie, as CardiSong describes them.

What the BDB piece shows

The piece describes a small Bulgarian medical research company that has built a portable telemetric ECG device making early diagnosis of cardiological conditions easier. The company, Innovato Clinical, was founded in 2015 by Dr Rostislava Dimitrova, a physician with long experience in national and European institutions, with the mission of improving the health indicators of a country that ranks among the highest for cardiovascular mortality.

The idea for the telemetric device took shape in 2016 together with the engineering team of Prof. Ivo Iliev at the Technical University of Sofia, a close development partner. The clinical trial was carried out at Alexandrovska University Hospital by Prof. Emil Manov and Dr Krasimira Koshtikova. Beyond doctors and engineers, the team includes patent attorneys, IT specialists and product designers.

According to the piece, a patient will be able to examine themselves at home and send their ECG as a sound signal over the phone to a doctor, who reads it and gives guidance. That makes timely detection, remote monitoring and prevention of cardiovascular events easier — which proves decisive in remote areas.

The project was approved by the Ministry of Innovation and Growth for a European grant, and BDB provided bridge financing through its instrument for accelerated absorption of European funds. “Without the European funding and the help from BDB we would not have made it,” Dr Dimitrova says in the piece. The device is planned to reach the market by the end of the year.

The emphasis, in the piece and in CardiSong's own approach, stays on the doctor's role: the device provides a recording, while the clinical judgement rests with the specialist.

Why the recording is sound

The CardiSong device is a unit for transmitting an ECG remotely as audio. It has steel electrodes, an ECG display and an audio transmitter, and the device itself needs no internet. Heart activity is converted into an audio signal that the phone picks up; that is what looks like a phone call in the video.

A recording lasts about 20 seconds. The CardiSong app records the sound, checks its quality and sends the audio file encrypted to the platform; if you have no connection at that moment, the recording is kept and sent automatically later. The alternative is the CardiSong phone line, which needs no internet connection.

The device runs on two AA batteries and needs no cables or Bluetooth pairing. A relative can set the app up for you, once, at first use.

The doctor's role

The platform converts the sound back into an electrocardiogram. The recording appears in your doctor's profile alongside your earlier recordings in time order; the doctor reads it and sends you their opinion through the platform. You are notified when the result is ready, and the timing depends on your doctor's availability. If the doctor judges that the condition needs urgent attention, you also receive an urgent SMS notification. That judgement is theirs: the platform does not decide which condition is urgent.

Monitoring starts with registration with a doctor who works with CardiSong. The doctor decides when and how often you record.

Limits of the method

CardiSong records heart activity only during a recording you start and does not provide continuous monitoring. It does not replace a prescribed Holter study or a standard 12-lead ECG, and it does not diagnose. Reading the recording and giving an opinion are your doctor's work. CardiSong is not intended for emergencies.