Kansas Cardiologist Improves the Stress Test Experience for Women

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March 8, 2021 — University of Kansas Health System Cardiologist Ashley Simmons, M.D., knew there could and should be a better way to measure female heart function. She had seen countless women balk at the uncomfortable testing that requires patients to go bra-less. She'd also seen many cardiac sonographers struggle to place the precordial electrocardiogram (ECG) leads appropriately and has even seen the leads fall off due to basic breast motion. Simmons had tested hearts for years but could not understand why someone had not made a bra that would support women's breasts, assist the sonographers with placement, and allow for more accurate measurement. Frustrated by the lack of innovation in this department, she set out to improve the stress test experience for women. It was then that CardioBra began. Most exercise stress testing is performed on women without a bra in place. This is to allow for rapid access to the chest wall for acquiring ultrasound images and to minimize potential artifacts in nuclear stress testing. But many women arrive for a stress test expecting to be able to exercise with a traditional sports bra or other breast support garment. Women are uncomfortable and embarrassed when they are told to undress—and most facilities offer a thin gown to cover the breasts—and zero support. "I found it so strange that breast support wasn't available for these tests," Simmons said. "Some women experience breast, chest, or back pain due to exercise without breast support. Some women will have a non-diagnostic study due to inappropriate ECG lead placement or ECG lead artifact from breast motion. Some women will refuse to do the study at all due to religious or modesty reasons. There had to be a solution." Simmons created CardioBra (a patent-pending garment) with a design that limits breast motion, promotes accurate ECG lead placement, and reduces ECG lead artifact. The design of the garment allows rapid access for echocardiogram image acquisition and limits artifacts in nuclear stress testing. CardioBra also improves patient comfort by only exposing the breast in areas where needed for the exam AND provides much-needed breast support. CardioBra is a two-part system, uniquely designed to work with Claravue electrodes by Nissha Medical Technologies. CardioBra used with Claravue reinforces electrode adherence and promotes ECG lead placement under the breast with added support. Claravue's low-profile pre-wired design eliminates the pinch clips allowing for a comfortable fit. "All technicalities aside, at its core, CardioBra is about improving the stress test experience for women. The bonuses are improving the quality of the ECG and reducing the need for additional testing," Simmons explained. CardioBra is designed to place ECG leads accurately and to reinforce ECG leads so that they do not fall off during all types of echocardiographic imaging. The bra allows access to the skin rapidly at the end of exercise stress to allow rapid echocardiographic image acquisition. The chest wall is only exposed in the area needed for image acquisition. Breast compression and elevation improves comfort while also minimizing motion during stress. The ECG layer stays secure with less breast motion, is radiolucent for nuclear imaging, and minimizes artifact on myocardial perfusion imaging. "Nissha Medical Technologies is pleased to partner with CardioBra and contribute to the mission set forth by Simmons to offer more accurate measurements and increased comfort during stress test procedures for women," said Peter O'Loughlin, vice president and general manager of Nissha Medical Technologies. CardioBra is available for purchase at Henry Schein, Premier, and CardioBra.com. Claravue pre-wired electrodes are available for purchase at Nissha Medical Technologies Healthcare Solutions Ashley Simmons, M.D., is the medical director of The University of Kansas Hospital's Adelaide C. Ward Women's Heart Health Center. In addition to specializing in women's heart disease, Simmons's clinical focus includes echocardiography, cardiac CT and MRI, and clinical, consultative, diagnostic cardiology.