Project of the Slovak Research and Development Agency (APVV) APVV-14-0875

Project duration: 07/2015 – 06/2018

Principal investigator: doc. Ing. Milan Tyšler, CSc.

Ventricular arrhythmias caused by conduction disturbances or structural changes in the myocardium are one of the causes that can lead to decreased pumping function and symptoms of failing heart. If the pharmacological treatment does not lead to desired effect, currently the second option is a therapeutic intervention based on application of an stimulating electrode or catheter ablation of the arrhythmogenic substrate. In both cases exact localization of the site of abnormal activation is necessary. In classic therapeutic practice, this place is searched during the intervention using an intracardial catheter under fluoroscopic control or by endocardial electroanatomic mapping. With increasing accessibility of tomographic examinations, currently also techniques how to determine the site of intervention noninvasively before the treatment are searched. Methods of so called electrocardiographic imaging seem promising that combine data from surface ECG measurement with tomographic data and use a mathematical model to reconstruct the myocardium activation sequence. General solution of this problem currently does not exist but successful localizations in specific pathological cases were published. The main objective of the submitted project is design, optimization and verification of a measuring method for noninvasive localization of one or two small areas with abnormal ventricular activation. The method is based on multichannel measurement of surface ECG and an individual 3D model of the patient chest obtained from tomographic imaging. In contrast to other published methods, the calculation of the site of the pathological substrate is based on a mathematical model of the electrical field generated by one or two local sources in the heart. The proposed method seems enough accurate and robust for the given goal. Noninvasive localization of the of the target area enables better intervention planning, shortening of the intervention time and decrease of the patient load. 

Selected publications:

1. TYŠLER, M. - ŠVEHLÍKOVÁ, J. - PUNSHCHYKOVA, O. - KNEPPO, P. - MAKSYMENKO, V.: Noninvasive localization of ectopic ventricular activity using BSPM and different patient torso models. In ELNANO 2015 - Conference Proceedings. Kyiv: National Technical University of Ukraine, 2015, p. 325-329. ISBN 1467365343.

2. PUNSHCHYKOVA, O. - ŠVEHLÍKOVÁ, Jana - KNEPPO, P. - GRÜNES, R. - SEDOVA, K. - SENYSH, B. - OSMANČÍK, P. - ŽĎÁRSKÁ, J. - HEŘMAN, D. - TYŠLER, Milan. Influence of modeled heart cavities on the noninvasive localization of ectopic ventricular activity. In MEASUREMENT 2015 : 10th International Conference on Measurement. Editors J. Maňka, M. Tyšler, V. Witkovský, I. Frollo. - Bratislava : Institute of Measurement Science, SAS, 2015, p. 109-112. ISBN 978-80-969672-9-2.

3. PUNSHCHYKOVA, O. - ŠVEHLÍKOVÁ, J. - TYŠLER, M. - KNEPPO, P. - GRÜNES, R. - SEDOVA, K. - SENYSH, B. - OSMANČÍK, P. - ŽĎÁRSKÁ, J. - HEŘMAN, D.: Neinvazívna lokalizácia ektopickej komorovej aktivity s použitím rôzne presných modelov torza získaných z CT hrudníka. In: Lekárska fyzika a biofyzika na začiatku 21. storočia 2: Aplikácie fyziky v medicíne, Zborník abstraktov, UK v Bratislave, 2015, p. 40. ISBN 978-80-223-3953-7.