Vagus ECG Smartwatch Intro

I guess I'll just do a quick introduction and then I'll like Gustav's just sort of take things from there um so Gustav crank is a longtime sort of friend of mine through the quantified self community we probably met I don't know maybe eight years ago seven years ago at one of the Key West events in Europe and we've always kept in touch and he's been working hard on this new technology really around sort of understanding the vagus nerve and how to sort of understand and measure what's going on in the body physiologically and then he'll probably talk more about on the road like ways that potentially impact it and Gustav's are the folks that are on the call now are all sort of New York area based friends part of those sort of biohacking community here we've got a pretty good group here Wow so I think we're gonna record this too so that as new stuff does is demoed and he's gonna probably get a little bit of my data I could share this for people who couldn't be on the call so I'll let Gustav just take it from here I think we're limited to about a 40-minute call I'll mute myself okay thanks very much but it's great that everybody who's there I will go through but I'm really happy you find time to you a little bit listen to me or look whatever I have to show if it's of interest yeah I'll stop just try and then if I get talked too much and whatever Bob interrupts me it's I get enthusiastic and I and so sometimes it just do rub me but I'll get to short background so you understand I had totally I am an engineer I have a master's in engineering also electronic working on that I had a lot of companies had a global group and I managed to open a factory in 2008 subsequently the whole financial my whole group was in really dire problem and who doesn't attend I had to burnout and I was quite the guy who considered myself smart my ego was a really big in and so of course I thought that's not possible but I was really bad shape and a board member got me to something called the person of meditation just a quick when I say the person are going to meditation how many of you have been ah yep okay familiar to you anyhow what happened to me was totally mind-blowing it saved my life and that I came out and said if I get rid of the steel and industry other then I'll devote the rest of my life I'm trying to figure out the technical solution for what happened to me during the ten days and the passion and so that's basically what I then I've managed to get rid of my industrial group the following year I didn't go bankrupt but I sold it for one euro and got to keep some other loans but I had I'd still even if he punished and I helped me I still had anxiety and depressions and so I basically went built the lab tried to figure out how to help myself without SSRIs I presume serotonin to present whatever you know depression medication hidden there was a suicide pills for me so I had to figure out something else and I was with passion I combined with something where I just accidentally discovered beggar stimulation so I built devices for myself on stimulating the vagus nerve and that's also the reason then I'll just come to my watch but this is kind of a unique the vagus stimulation and the watch the data and the stimulation is a whole entity and that's why I do what I do so since 2011 I've been doing this pretty much full-time and yeah it's a long journey and I say I'm gonna do it still 20s but just to explain I presume I'll have everybody heard a little bit about the vagus nerve does it yes definitely I'm really happy I maybe don't then start to explain all the details the main thing is for you guys to understand its enormous ly important of course no that's what you activate in the question of meditation that's what you should activate in order to not get anxiety burnouts and all this let's say modern diseases which exist today

so the Vegas now what what's important to understand it it's of course it's really a complicated map it's it starts in the brainstem it's the tenth cranial nerve and it it's of course not one nerve there's a lot of it and one goes down the neck on both sides or under the vagus nerve is under the outlier and it's quite a heavy-duty datachannel I always try to remind people that under my finger right now on the neck here and the vagus nerve there's more data than in all the internet at this moment so it's big data but it has an extension which is really interesting and it goes into the air it takes care of muscles in death in the face and so forth so it's basically I follow some professor Borges has something called the polyvagal theory and it means that vagal nerve as well many branches but it basically has two main branches it's called the ventral and dorsal vegas and the dorsal is the one which goes down to your stomach with the heavy data and it also takes care of your heart your lungs your intestines all internal organs it goes there and it's nowadays considered the key nerve also for immune responses and support so it has enormous influence on what we call homeostasis and immune so the vagus nerve is critically important what so I'll explain it from that perspective probe because what we will what we are doing in medical terms or in trials is stimulating the neck and also on the air and doing that and very early on five six years ago I noticed we like houston we got a problem with with stimulation because people are different I was doing 50 people and they reacted of course differently on different frequencies and then if they used our prototypes we had like 100 prototypes that they it were off so I needed to individualize and know in real time which stimulation mode is good so then I developed an ECG and I was one year at GE healthcare incubator in Finland or they discovered that at least they don't have very advanced electronics so we built our own hand to hand ECG or 85 years ago which was a ring to get a real-time monitoring a feedback from stimulation and so in the past five years we've been using this for trials and so forth and yeah it's been extremely helpful and so the reason for today's meeting is that over the years it's a little bit thinking temporarily over this kind of handle and ECG and especially a couple years ago when then Apple came with the watch with the ECG so suddenly everybody was starting to talk about where the ECG and we are now in a new lab in Cambridge where we do Diagnostics for clinical trials and then a lot of these discussions we're already many years ago that we need something to give to the participants in a trial it's called a longitudinal following a participant so we need data from from participants we need them to to follow them to see of course other things also not the ECG we needed that pvt levels we needed sleep we needed movements and we needed a nice device which is not final hassle and so forth so I ended up ditching in the ring and doing a SmartWatch which was luckily kind of that the technology had then a couple years ago becomes so common and there's good trips and so forth so we didn't I study I tried to talk with Apple I know my personal friends there were they of course refused giving today that we applied from Cambridge University for clinical trials and they laughed at us they were only given some data to Stanford and Johnson & Johnson this far and they had made in my friend of never they will not give raw data so I can't use their data and anyhow I thought it was quite unusable and then the other word to make is the same so we had to make our own and that's where we are now and of course we are then launching it as a consumer device now well it's because we need to produce a lot of them and we need a lot of experience from consumer debt because we

need we need data to be able to help in the clinical trials so it's a little bit Cottontail the more data the better we can figure out and of course for our purpose we aim to we think our consumer version of the Vega stimulation in the air will come out we will get it ready next year and we know already now from over the years that our biggest issue is that those who want to use a Vega stimulation they should already have accumulated data from extended period so that I need to know when the user is in good shape and I need to know when he's in bad shape when he is perfectly happy when everything is going on and when he's really sick and Gillian these are basic data which we then can use for the biggest immolation and it's pretty simple because the Vega stimulation is with only last 20 minutes or 30 minutes programs and we are following it in very quick in real-time almost in real time we take kind of 5 or 10 minute intervals to see how it influences and so we need this basic information in order for AI to determine which stimulation program is suitable for the person in question so it's a little bit a big question why we do this but then story is that yeah now it's launching that the watch because we think we should have users we need and we can give something which nobody else can give so I published our study from Cambridge studying in April it was about bagel toad with hand to hand ECG because the main thing is that up to now all the watches are following heart rate variability which is in itself an interesting value I don't really like it I will actually show it to you why heart you should be careful with attract variability because in the terms what we use it for stimulation I basically say it unusable at rate variability as a value is in data send some information stance not a good value for doing Diagnostics poor for the vagal tone on short-term for long term for four weeks or four days and so forth a vagal measurement through hundred variability is the okay but remember it's okay at best its long-term average which then tells but it's not on short-term it will not tell you how you at this moment actually feel or how you're healthy so this is something where I am Bob how am i doing shall I start through the features of the watch now yeah I think a lot of people want to see maybe a demonstration at the lodge I know on the website there's not really any images of the screen so people probably want to see kind of what I know you're developing the software still a little bit maybe show how we'll walk through and I know you've got one my dear yep and I jump in real quick this is sage I just have a quick question you went into the dorsal vagus nerve can you just talk a little bit about the ventricle and your experience with that just close that loop for me please for the move on yeah well it's very essential why we do what we do okay so the ventral is in the air it's atom alienated the vagus nerve and it's it is different from the dorsal which goes down here and it's unmyelinated but the dorsal takes care of the heart heart rate the variability or the dorsal is coordinating breathing with the heart so one or the only parameter we have a vagal tone is today something called respiratory sinus arrhythmia and that is how well the vagus nerve is synchronizing the pulse to go together with breathing so that is the dorsal measurement but in practice we know from stimulation these two are basically kind of place twice on the same place virtually exactly they have a little bit different origin but they are so close that a modulation of the ventral vagal also modulates the dorsal

Babel because we can't and non-invasively we can't influence so precisely that we only influence the ventral did I answer your question you did until I hear you say that the ventricles are myelinated no the ventral a ventral is myelinated the dorsal is unmyelinated my lean on it when the ventral which is up here as my lean on it correct thank you so but it's very important because for when we do vagus nerve and you understand so my starting point was the vagus nerve I wanted good data on the vagus nerve and we didn't find it any we're heart rate variability it was a non-user we could not use at rate variability for stimulation purposes because it does not function on short-term periods and hundred variability has very many flaws and I will show you one practical example from yesterday actually on myself so but I'm going to the watch so in order for to measure vagal tone to measure help how does your vagus nerve function it must it can be measured from the thing which is called respiratory sinus arrhythmia so when we breathe in and then the vagus nerve is increasing pulse in order to pump out more oxygen and it's also adjusts in the lungs something all the bronchiole is so it kind of fluctuates is a wonderful most advanced kind of system of full control of homeostasis and especially that the cardiac respiratory kind of integration is critical so just to look at the heart is not wise if you want to understand whether or not the vagus nerve is working properly this is scientifically a fact so just to look at heart rate variability without looking at breathing it tells you nothing because there are many factors who can cause variability of heart rate but if you couple heart rate movements with breathing and you look at these beat that that's when you start to get into doing to the truth about the vagus nerve so that is the vagal tone and then professor Borges for instance then say respiratory sinus arrhythmia was up till sometime ago the best ones but I was difficult to do and what we can do now is I discovered which we discovered all the fact it is that when you breathe in deeply more deeply you your heart position is moving a little bit and this position movement actually the placement of the heart because it's under your lungs this causes the QRS amplitude change and this amplitude change is the extremely precise measurement of breathing so because it doesn't change unless you move your chest and you move the position and it well you can do it any other way than breathing so it has been known already for a long time that on the electrocardiogram electrodes here on the neck it can be seen it doesn't it's not seen here on a chest band because it needs to move its B's electrode or then electrons down in your feet but that's impractical but what I discovered that of course hand to hand electrocardiogram is an extension of this EVR electrodes so what we do under and now I'll sorry I come to the point so I'll show what we do the main feature I this is not what it takes phone calls it messages follow your steps it follows your optical pulse and all this normal stuff we do it and we tell the clients we have all these features but the main thing well I hope is people to do by these and use it because it gives a totally new type of data and it gives much deeper information on a person's autonomic nervous system than anything before and so what we but in order to really we've done 10,000

electrocardiogram tests for five years I always said I think I've done more than anyone else nobody's challenged me on that so I'm pretty much a specialist on hunting on the ECG we also had yoga center here in France so I've been doing a lot on Yogi's and so forth the meditators and feelings are like done on people who are less healthy let's say think a lot about pilots what so I know all the different but to get the real data so now maybe I should let's I'll show that so in electrocardiogram you have one measurement point under the watch and the other one is on the side of the watch so a hand-to-hand ECG of course it's necessary for you to have the hands so you need both hands and don't believe apples way to measure ECG like this it's just my opinion your because it's it becomes a lot of muscle activity and then they make some kind of movies like I say there is it is more Hollywood movie than any real science or data but they are going to sue me much probably if I say that sort of better not to quote me too much on it but anyhow so what we do with the watch is of course it's known what time yeah nice with that then there's this what's its number I'm going wrong way so it's a swipe it gives how many steps you take how can you sorry can you see this by the way now I yeah just minimize your movement so that we get a lot of blur and you move it so yeah I fixed one sorry trying to do that okay I have it on so you will see at the same time so these are the steps and then I have these Vegas come back to that that's a various test then we do a base ECG this is 30 seconds test and then it has an optical heart rate so this is the normal it follows optical so there's basically different ways to follow the heart and then I also have a breathing exercise this was something which we talked with Baba it's closing the screen very quickly because it has a long battery time I hate charging so I think it's eight days since I charged this last normal we say five to seven days but if it lasts up to ten days even in normal use and then it takes two hours to charge it so it's on but look it's because uh you just swipe but the main feature then is the Vegas ECB test and when you press that one you see so you see how the sorry about this rule number one always test before your conference call it's the time check you've got about ten minutes left on your yeah the best you do is like this you press Vegas test and then you rest your hand you put here and now I think you can see the screen first it takes thirty seconds it takes a base ECG distress to your hands and after that it's going to ask you and show you how to do the control breathing and I use five seconds inhale and five seconds exhale four for sixty seconds right now the screen of your we're just seeing reflection on the screen just to focus is off but basically what it's doing is there's a 30-second countdown you breathe normally and then after thirty seconds it'll give you a five-second countdown and then tell you to breathe following a breath pace or five in five out over the 60 seconds and then that's how you trend you're reading some so it doesn't really see there but it ask you it gives you it in color and instructions went to Sega we can see it now you see it changes between inhale so now you take a deep abdominal breathing in and then you

breathe out for five seconds so you just follow this instruction that's all you need to do and when you done this for 90 seconds it sends it into the app that sends into cloud we do the analyzes and you get the data and this is the key issue which we need to have because with this data we really can take this show what the heart okay after doing this test now it goes into the I won't start showing the app that is or I'll go directly into the day that is if this is okay so I'll show you for you to understand what really is that - let's see I'll share I think it's there can you see this screen now yes okay so I'll explain quickly for you to understand what does it really do so this is one result and this is the one I've been kind of showing also Bob and so forth this is Bob this is you in the morning the red line here is the heart rate during this control breathing face so how the pulse goes up and goes down and since we can measure exactly breathing also now with this way we get exactly the blue line how breathing goes in and out so this Bob has really good breathing and then we can see exactly when the pulse builds up and when it goes down and you can see from the graphics here you understand that his pulse starts going up a little bit before his is inhaling which is good that's what it should do it continuous maybe a little bit too long but it's good anyhow this was already really good measurement really good data which you had in the morning and all the data so we if you see bottom line you see we keep breathing we give because we also look at heart rate variability as a number people want that minimum resting heart with the I heart beat but especially we take the respiratory sinus arrhythmia our sa how well the peaks of the heart and the peaks of breathing our Sigma and then how are they synchronized how well is it going on da so this was Bob today I mean you're healthy you get a good healthy journals from that I'll show you another one which was yesterday for you to understand why hundreds were abilities this is me before I did a stimulation program actually I yeah I test a lot of stimulations and I do very stimulation almost daily for myself for the past six years yeah some say it's that's why I'm a little bit strange but better but I like it helps me so my red is my heart rate and the blue is my breathing in a normal stage and I have a little bit too early this is a so my value isn't that good it's only 59 is their index there but the points I want to show it then I did something on the Vega stimulation on bagel blocking and now you're gonna see first ever graphic what happened when I do vagal stimulation by not blocking so you can see this is me and there's 10 minutes between these two I'm just sitting still this is before and this was after the bag at the end of 10 minutes 15 minutes I think bag of blocking was here so you can see how my heart goes up and down which means in this graph you see have a very high heart rate variability extremely traditional you would say Gustav is in great shape that's I'm not I actually blocked vagal tone to the heart and the result is that my heart my vagal tone was very low so you maybe see on the RSA so I had a very low vagal tone but heart rate variability was very high and I was not this is not a good stage but there are reasons due to immune with what we do immune we need to block the dorsal bagel and even if I get a low hot bagel toad at the same time I block out the immune responses so this is really very good result people don't really realize it but these are ways I can see extremely precisely about the state of a person I've been doing hundreds and hundreds of

thousand people and I can see immediately in the date that can show me if they have severe disease or if they're something is really wrong with their autonomic nervous system so we just need these 90 seconds and this data is just yeah I haven't seen anyone else in the world do it it's them after the conference in April people work where they want me to have these watches at the Veterans Hospital in Boston and so forth now we are supplying to stop hospitals and for some clinical trials but I would like to have normal consumers to learn and understand get the data on themselves and to learn much more so well how am i doing with time so this is the fundamental these are data parts which we give to the users I can I'm a cue as I was active in the data right so the user owns the data the user can get the rod ECG data and so forth from base that's what we call the data Explorer package some days it's a little bit work on a construction I will only supply in middle February we supply those which I ordered now and I will only supply 100 watches first I want to say the first 100 how people are using the data and so forth and then we open maybe for the next batch which will be in April May so I want the first hundred users of the watch to get this data to learn and see so that is the process we are in at the moment I so sorry I'm speeding up here questions so do stop just to clarify you're doing manual analysis at the moment of this information so you gate is gathered on the device uploaded and you'll look at it you've you you're sort of looking at it with a set of expertise you can kind of based on the ten thousand plus scans you've looked at eventually this is going to migrate to something that's probably a little more automated and can get they can extract the sort of insights out of it but for now it's a manual look you have the raw data but you're able to interpret it for us so if I send you my information you're saying I look good or I'm stressed out or something's off just so people understand like there's the device there's an app but really the analysis is still being done manually no but that's why we I actually have the watches already but we are not gonna start supplying until middle February and app is ready so we're working on the app so that this data comes back in that this graphic actually you can open the app you will see okay and you get all this vagal tones all these data and you can see your historical for the past week we're gonna have the past ten days I'm gonna show how you evolve your Avego tool and when it's down and when it's up so you will get numerical values of course we this is this will be when we ship the first hundred and that is ready so just in terms of the group on this call so a lot of the folks here are doing a lot of things with breath work instead of trying to manipulate our physiological state so I can see potential applications here from a raw data standpoint even where you know beyond doing the control breathing you've got were you trying to compare five second five seconds people can figure out optimal breathing patterns or things to put themselves in the optimal let's say parasympathetic state at any time by looking at what where do we optimize these curves these graphs based on different breathing that'd be something happens again then right now I'm not gonna give out you have one pub I have a few better beta testers but because I do it manually I send it out so we're not gonna have more beta tests until the app is doing it automatically in so that will come for the first 100 but I'm saying that for the first time what I do with the nerve explorers the package we have agreed with my team is that we take this first 100 and if they'd use the watch sufficient there we say 2 months of data we go in and do manual diagnostic sources for them so then I don't have I can't have a thousand users who put me questions could you look at yesterday's data the day that shows like that could you look at it and say so in order for me to be physically able to do Diagnostics also for this day that was then we limit it to a hundred not know I guess the climbing by yeah sorry oh no sorry I was just meant to clarify I understand the analysis and opinion you've got thousands of users but I'm saying because there's raw data there's other applications for how this device can be used like it meaning if

somebody else wants to look at the data and correlate things with meditation breathe breath work all that beyond just the baseline you know my body state on any given day they'll have access to that information um yes yeah I wanna I want people to discover also what they can do with raw ECG hunting and data this is the best buy a signal data available I've been playing around with AJ's for ages and I'm just saying that each interpretation is so and so I mean it's just so interesting to look at data for the first year but after that you're not it doesn't tell you my I find this much more informative than AG actually this is so I think for people doing breath work they must look at this data because it's the critical component of why we breathe in controlled manner why we do pranayama in yoga and all these we need to see our people responding properly and if they don't this is very important so this will you get so I have a question for you I do 30 to 45-minute breath work sessions one-on-one on a regular basis I would love to be able to tell exactly at what points as we're graphing as the journey is being created what we're doing bio biologically physiologically and can this be in any way extended to neurologically with brain states can we infer brain's states alpha beta delta theta gamma mu any of that from your data or is that something that could be worked in or with an API in the future so that we can get bio and neuro data yes I do EEG so we've been doing in Transtech lab been in Sofia University we did a lot of EEG combined with this ECG okay so I know that if you have control breathing and your vagal tone is high you will we will raise your theta or sorry a decrease depends in a little bit or the person actually I decrease my pedis others so this is individual but so we see correlations and these are pretty simple when you tested it a few times then you usually know how a person reacts in eg from this vagal tone yes can someone use this during a breath session without having they need to have both hands touching the phone so if they pass out or if they not blackout but they go into a Samadhi state someone needs to have their hands fastened we would need to find a way to keep that second hand on the watch correct yes the chair and you leave your left hand on your foot and then your hands crossed in and then we can follow but I've been I'd be very careful we don't have real-time monitoring so I'm not I can't do a half an hour because it's not informative I have another drink and ooh we can take 1 hour 2 hour sessions with the ring but it's really troublesome to pick out the details and so at this moment we just have the 90 second test and then so you need to attempt to do to remind him that now you restart the 90 second and do that for instance with 10 minutes intervals then I know how well is the breathing session going yes okay let me ask you about heart coherence that's why you're doing five and five out right that's based on heart math and Patricia garvenberg and Browns work around coherent heart coherence this is based on very much older this is science where usually you have an 80% policy for the reactivation on five seconds in here is a physics here this is nothing to do at Matt's studies it's just the fact that our bodies usually we breathe two to three seconds we inhale and exhale so when you are at five seconds then you already have 80 to 85% activation of parasympathetic regardless of anything else so you this is I'm not I don't want to kind of mix apples and bananas here so what we do from scientific point of view is that this is how the vagus nerve works it has nothing to do with breathing coherence it is just the functionality of the vagus now I'm an engineer it's like if you press the gas in a car it goes faster so it is how the vagus nerve works and should work and if it doesn't work that way then we also know that medical and scientific sometimes not always we go in and look at it so it is yeah automatics is a derivative of this fact but it's

it's nothing special it's just how the body is constructed yes got it so if I'm pioneering which I am new breath patterns your device could tell me what I'm doing physiologically at any point 10 minute intervals ideally at 90 second readings you could map and tell what's going on in a person and track over time what we're doing in sessions and then ultimate benefit at three months six months yes I with clinical procedure I would the prime thing what you can do with this is say that will be this person benefit from breath work in generally or does this person have autonomic nerve dysfunction if for instance autoimmune disease or a genetic disposition or other reason where he or she does not respond to breath work and then what we say is that if if breath work practice doesn't work then we send up the doctors we do the immune lab test and so forth so the main thing is to be able to tell the person the patient that will breathing it is this going to help them because for most it will help but not for all so I can separate those who are not going to find a benefit from breath work because we can see quite early that there is a fundamental problem with the vagus nerve do you follow me sorry I do know I do that's fascinating the reason I am really personally fascinated that Louisville is because I suffer from a number of autoimmune and neurological autonomic nervous like ten of them going on at all times and I do breath work for myself first so that I can function at any level without opioids or other forms of traditional medication but I have no idea what's going on in my body and I can do some pretty crazy stuff so just personally I'm fascinated because I know what I can do but I have no idea what it's doing inside of me and so I'm quite keen to get involved in this and just figure out because no one's been able to tell me what an accident with peptides did to my nervous system in my bagel tone I have a very high HIV I'm like 150 milliseconds at night which is really not indicative of what's going on so everything you're saying rings a bell and I'd love to begin to integrate it and talk about how we can put this to work with the breath work stuff that we're already pioneering thing but I just wanted to say thank you this is so informative and exciting because up to this point HRV has really been the only thing that I have at my disposal to help a client's right like to help support a more precise program to help people achieve a higher level of fitness and so this is really exciting I'm really excited and grateful thank you that's wonderful yeah I want I'm not trying to say that HIV it's good for it's a start point and it's good for longer-term measurements to understand but I just I'm always so scared and I get so frustrated when people are kind of praying to the HIV and saying this is solving their life and I'm just no it's not it's unfortunately not the truth I mean one of the funny things is one of our tagline is data don't lie but ironically we all know that we're just trying to find better and better data points we know that it's just informing us there's no such thing as perfection in this search and so I'm always looking for a better way and I'm excited when I get to connect with someone who's obviously doing really groundbreaking work thank you I let I really hope to be able to work with you it's thanks again Gustav and I guess if anyone has questions you're the website is a Vegas CEO right yes and then I could put you yeah Gustav G USDA F at the Vegas that CEO just put me man's and questions and I can I have a version of the study also I can say to you guys with it's not the full study but it's official with a public agenda so okay just your email excellent all right well looks like we're coming up on an hour so I guess if there's no other questions we'll uh we really appreciate you taking the time today to uh walk us through everything I mean this is all as you know like I got about this stuff and it's um you know and I feel like you think you know a lot and then you learn more so you know it's you have to kind

of keep reevaluating and you know it's exciting really happy if I can help you guys to get deeper into the human body almost aaseesh the understanding of that immune system and the autonomic nervous system this I think is critically important stuff great all right well thank you very much everybody everybody hey thanks bye