Projects

Dominik Štolfa

Project selection:

National projects

ReAcMap – Assessment of restitution of normal ventricular activation by ECG mapping
Vyhodnotenie reštitúcie normálnej komorovej aktivácie pomocou EKG mapovania
Program: SRDA
Duration: 1.9.2025 – 31.8.2028
Project leader: Ing. Švehlíková Jana, PhD.
Annotation: The project intends to optimize and personalize cardiac resynchronization therapy (CRT) for patients with heart failure. This effective, nonpharmacological, pacing-based treatment aims to restore interventricular resynchronization of ventricular activation by pacing both ventricles with an expected subsequent increase in cardiac output. However, about 30-40% of the patients do not benefit from the therapy and are designed as “non-responders”. To improve the efficacy of ventricular resynchronization, conduction system pacing (CSP) was recently introduced into clinical practice, which replaces biventricular stimulation with direct stimulation of the conduction system. However, CSP to achieve a narrow QRS complex is not feasible in up to 15% of patients for multiple anatomical, pathological, and technical reasons. Therefore, an optimal individualized strategy to achieve effective ventricular resynchronization is an unmet need in electrical therapies in heart failure patients. The proposed research project is methodologically based on noninvasive body surface potential ECG measurements of patients with heart failure indicated for a CRT/CSP device implantation. From the measured data, conducted using a dedicated in-house measuring device, the new parameters for the evaluation of the dynamics of the ventricular activation will be derived to set the proper programming stimulation of the device. A possible reduction of the number of ECG electrodes from the currently used 128 will also be studied to facilitate the routine clinical feasibility of the recording system. The simulations of the failing heart will be performed to understand better the processes that are undergoing in the ventricles. The area of the starting spontaneous ventricular activity will be assessed by solving the inverse problem of electrocardiography using a personalized heart-torso model obtained from the CT scan. The dedicated measuring system will implement a GUI to apply the suggested methods easily.