VDI Vision - Analysis of Ventricular Electrical Dyssynchrony in Real-time

Filip Plesinger1, Ivo Viscor1, Vlastimil Vondra1, Josef Halamek2, Zuzana Koscova1, Pavel Leinveber3, Karol Curila4, Pavel Jurak1
1Institute of Scientific Instruments of the CAS, 2Institute of Scientific Instruments, CAS, CZ, 3International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic, 4Cardiocenter FNKV and 3rd Faculty of Medicine in Prague


Background: Ventricular electrical dyssynchrony can be examined using ultra-high-frequency (UHF-ECG) analysis. If the analysis could be made instantly, it minimizes measurement time and allows direct optimization of pacing location. Here we introduce VDI vision, a desktop application for the acquisition and real-time processing of UHF-ECG recordings.

Method: Incoming ECG data (5kHz, 26 bits, 24 channels) from acquisition hardware (M&I, Prague, Czechia) are encoded from UDP packets. The ECG signal is processed as follows: QRS detection, pacemaker stimuli elimination, QRS clustering, amplitude envelopes in several frequency bands, and final combination into the dyssynchrony map. The map is displayed, and it is updated whenever a new QRS is detected in incoming data. The graphical user interface also contains sections to check key points of the process.

Results: We developed the VDI vision using the C# language and .NET platform. Until the end of March 2021, the VDI-monitor was used to analyze 773 and 4,849 recordings at ICRC-FNUSA hospital (Brno, Czechia) and FNKV hospital (Prague, Czechia), respectively. The median length for ICRC-FNUSA recordings was 124 (IQR 121-139) seconds. The median length for recordings at FNKV hospital was 157 seconds (IQR 127-200), less than half of measurement time from former off-line processing (median 323, IQR 312-366 seconds). Recordings were acquired from healthy subjects and patients before, during (FNKV only), and after pacemaker implantation.

Conclusion: The VDI vision delivers information about electrical ventricular dyssynchrony in real-time. The instant analysis allowed using the software during implant procedures for optimizing electrode placement and pacing. The presented real-time solution also significantly minimized measurement duration.