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 designated 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 dynamic 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 GUI to apply the suggested methods easily.
The project is realized in cooperation with the Faculty of Medicine Comenius University. The patient measurements will be conducted in the National Institute of Cardiovascular Diseases.
 |
Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia is dedicated to basic research in measurement science, methods for processing of measured data and development of measurement systems for biomedicine and material science. It offers advisory and expert services, publishes the journal Measurement Science Review and provides postgraduate education. For the project, the long term expertise of the Department of Biomeasurements in model-based diagnostics of the cardiac electrical activity will be utilized. Principal Investigator Ing. Jana Švehlíková, PhD., Email: jana.svehlikova@savba.sk |
 |
Medical Faculty of Comenius University, Comenius University, Bratislava, Slovakia the role of the Faculty of Medicine in Bratislava of Comenius University in Bratislava is to provide an undergraduate general medical education as well as postgraduate education through courses in specialized studies in the health professions, training courses and doctoral studies. Study programs of general medicine and dentistry are offered either in Slovak and English. Training of new scientists takes the form of doctoral studies, which has two forms: daily and external. Faculty of Medicine in Bratislava is an institution of lifelong medical education. |
 |
Department of Arrhythmias and Cardiostimulation National Institute of Cardiovascular Diseases, Bratislava, Slovakia is the premier clinical and academic facility for heart rhythm disorders in Slovakia.The Department provides comprehensive diagnostic and therapeutic care for children with heart rhythm disorders from across the entire Slovak Republic. This care is provided to children with structurally normal hearts as well as those with congenital or acquired heart diseases.
In addition to pharmacological treatment, the therapeutic options include interventional procedures such as catheter ablations and the implantation of electro-impulse generators (pacemakers and ICDs). Our advanced treatment methods allow for the definitive cure of many patients. |
 |
Přibilová, A.– Švehlíková, J.– Šašov, M.– Zelinka, J.– Ondrušová, B. – Hatala, R.– Tyšler, M. Autocorrelation maps for optimal setting in cardiac resynchronization therapy. In: Computer Methods and Programs in Biomedicine, 2025, vol. 260, art. no. 108519, ISSN 0169-2607. Online: https://doi.org/10.1016/j.cmpb.2024.108519 |
 |
 |
|
| Fig. 1 - ECG measurement – anterior a posterior: Multiple lead ECG measurement of the patient with 128 electrodes on the torso -so-called body surface potential mapping (BSPM). BSPM is computed for each time step. | Fig. 2 – principle of the computation of autocorrelation maps (ACMs) from BSPMs. For each patient, one ACM is computed from all BSPMs. | |
 |
 |
|
| Fig. 3 – principle of the computation of autocorrelation maps (ACMs) from BSPMs. For each patient, one ACM is computed from all BSPMs. | Fig.4 – Left ACM of a healthy volunteer, Right - ACM of the patient with left bundle branch block. | |
 |
 |
|
| Fig.5 – Left ACM of the patient with left bundle branch block. Right – the ACM after successful resynchronization therapy. Patient is a responder. | Fig.6 Left - ACM of the patient with left bundle branch block. Right – the ACM after non-successful resynchronization therapy. Patient is a nonresponder. |
We support those who improve the world
Dúbravská cesta 9
841 04 Bratislava
Slovakia
Phone: +421 2 5910 4511
Email: umersekr@savba.sk
Web: https://um.sav.sk/en
Špitálska 24
813 72 Bratislava
Slovakia
Web: https://www.fmed.uniba.sk/en/
Pod Krásnou hôrkou 1
833 48 Bratislava
Slovakia
Web: https://www.nusch.sk/oddelenia/