Dr. Mohamad Alkhouli with Dr. David Cohen in 2022.
My journey was a little unconventional. I began with a greater interest in cardiology than in medicine more generally.
I like to read a lot about history and philosophy. So my interest started from a metaphorical background, reading about the ancient Egyptian civilization and the “weighing of the heart” ceremony they performed on their dead. As legend goes, the ancient Egyptians believed that at death, the heart would be weighed against both the good deeds and the bad deeds they performed in their lives.
So I was always fascinated by the heart as an organ. This was way before even high school, and definitely before my medical training. So I decided that I wanted to be a physician and a researcher of the heart before I even applied for medical school.
Early in my career (first year out of fellowship), there was a female patient who was about 40 years old, on dialysis, and had a complex hole in the heart, between the right and left atria. Because she was on dialysis, she had an indwelling catheter in her heart that was developing clots. The clots were moving to the left side of the heart and causing repeated strokes.
Once we figured out the problem, we thought it would be an easy fix. It was a complex hole, but that's my specialty. I thought it would be a half-hour procedure. But then we found that all of her veins – from arms to legs – were occluded. So there was no way to get into the heart to close the hole.
After consulting the senior doctors on staff, I explained to her that the only option would be surgery. She just had a stroke, so the surgeons weren't too excited to do the procedure, but that was the standard of care. She looked me in the eyes and said, “I trust you will find a way to do it, so don't give up on me. Don't be a chicken! I'm 100% sure I will walk out of this hospital with this hole closed without surgery.” It's uncommon to challenge the doctor to that level. I still remember her bright eyes looking deep into mine.
That motivated me to take a look at the research, and we found a way to access the heart through the liver, which I had not done before. We spent time researching methodologies and then mapped out the steps for the intervention.
We did it! It was successful. She walked out of the hospital and even volunteered to do a media report for a local TV station about her experience.
We frequently hear the notion that doctors should listen to their patients. I always believed in patient intuition, but this one was striking because she didn't know all the specifics, but her intuition pushed me to do more.
One shortcoming of modern medicine is that we tend to view patients as statistics, because that's how we're taught to think about patients: as data points. But I learned you cannot discount patient intuition and motivation in the outcome of medical treatment. Looking back on my career, I’ve seen many patients defy the odds simply because they believed they would. Others with seemingly straightforward conditions felt something was deeply wrong—and unfortunately, they were often right. Patients often have an intuitive sense of their own outcomes. It’s important to listen.
That experience helped shape my approach to the doctor-patient relationship throughout my career. As a physician, your job is to bring wisdom and a holistic view of the data, and give your opinion to a patient who trusts you. But really, it’s a bilateral relationship where we try to learn something from each other. So with every patient, I ask them about aspects of their life that are unrelated to the disease or condition. I ask them about their profession, their interests, the last book they read, or shows they watch. I try to walk away with one new insight from every patient encounter.
The phenomenon of having a magnetic field associated with every electrical signal is not new, and is well-known in nature. For instance, tiny biological cells have sodium channels that open and close, producing an electrical current that has a magnetic field around it.
So I knew the idea of magnetism in the body was important and had huge potential. But in medicine, we hadn’t paid much attention to it. That made me dive deeper into what body magnetism is and how it operates.
Through my research, I learned about the work of David Cohen, the father of biomagnetism. I read his first few papers from the 1970s. I had just started my executive MBA at MIT that same month, and I found Cohen’s phone number and called him. I said, “Dr. Cohen, I'm very interested in your work. I would love to meet up with you.” And he said, “Well, you better hurry up. I'm not sure how much longer I'm going to be around.” He was 91 at the time. So I decided to escape class and go that same day.
I had a bunch of questions. I asked him, “You started with heart experiments, and then you pivoted to the brain. Why was that?” He told me that cardiologists weren't interested in magnetism because electrocardiography (ECG) was new and easy, and he couldn't find allies in the cardiology sphere to work with. Instead, he found more neurologists interested, so he pivoted to magnetoencephalography (MEG) in the brain.
And that's largely how it’s played out over time: MEG is currently the standard of care for certain brain conditions – and has been FDA-approved for many years – while MCG is still evolving.
While interest is growing, it remains limited. MCG represents a fundamentally different concept from ECG. Moreover, biomagnetism often carries a negative connotation due to its perceived association with pseudoscience in certain circles. Also, among cardiologists, only electrophysiologists are typically well-versed in electromagnetic field principles.
Two years ago, I ran a Twitter poll asking cardiologists whether they had heard of MCG—91% said they had not. That response wasn’t surprising, given that early MCG studies were suboptimal and the results unconvincing. However, both knowledge and technology have advanced. We now have more robust tools and a growing community of engaged minds working together to meet the burden of proof.
When I met Cohen, I asked him whether the data embedded in ECG is more impactful than MCG data. He acknowledged that there are more data points in the ECG, but the more interesting data is in the MCG.
That was great context, and true for what we see in practice. If you think about the occlusion of coronary arteries, we know that almost half of the arteries that close completely do not produce a distinguishable signal on the ECG. So ST elevation is missed in many cases. And vice versa: Sometimes, ECG shows ST elevation when in fact the arteries are not occluded.
In our preliminary research, we discovered that MCG can actually bridge that gap. Furthermore, if you mix ECG with MCG, you get a much more accurate understanding of things like myocardial infarction or acute coronary syndrome.
Another important value of MCG is that it is non-invasive and scalable. With newer technology, it may even become portable soon. When you have that scale and you can accumulate a ton of data and unleash AI on it, you will have much deeper insight into any disease you wish to study. For example, we're doing a study on Long QT syndrome. We found that MCG might be more accurate than ECG in predicting or estimating the QT duration.
So I would say, overall, there are known opportunities within ischemia, coronary disease, cardiomyopathies, and certain rhythm abnormalities. But there is much more to the story that we hope to uncover in the next few years.
If you're talking medtech specifically, not biotech, I think MCG might be one of the more “up and coming” innovative areas. Granted, it's not completely new because it has been around for a long time, but I think the technology, and the approach to study the technology, is much more mature and sophisticated now than what it was before.
I'm very excited about MCG and I'm hoping that we're going to get a lot more deeper insight from it. It's one thing to replace a valve or to repair a valve, and it's another to come up with a technology that can teach you more about diseases. That is what makes MCG so promising at this particular moment.
Dr. Akhouli is a cardiologist passionate about bringing purpose and precision to research and translating it to impactful innovation. His research spans artificial intelligence, biosensing, computational fluid dynamics, heart-brain connection, and device development. Over the past decade, he’s published more than 500 peer-reviewed articles and received several prestigious honors, including the TCT Thomas Linnemeier Young Investigator Award. After completing an Executive MBA at MIT, he became Vice Chair for Strategic Partnerships in the Department of Cardiovascular Medicine at the Mayo Clinic, where he leads collaborations with startups, investors, industry, and academic institutions to accelerate the clinical translation of research. He also holds key editorial roles at leading journals, including serving as Deputy Editor at JACC: Cardiovascular Interventions. Dr. Alkhouli is also the Chair of the Scientific Advisory Board at SandboxAQ AQMed.
