Body Surface Potential Maps

GRANT PROPOSAL

Storing, visualizing and interacting with advanced Electrocardiograms

Raymond Bond, PhD Student

Email: bond-r@email.ulster.ac.uk

Supervisors: Dr Dewar Finlay, Prof Chris Nugent, Dr George Moore

Computer Science Research Institute and School of Computing and Mathematics, University of Ulster at Jordanstown

According to the Irish Heart Foundation, 10,000 people die from some form of cardiovascular disease every year in Ireland [1]. This is one reason why diagnostic cardiology has remained and should remain an important topic in research.

One of the most widely used tools in cardiac diagnosis is the 12-lead ECG. Although the 12-lead ECG is the most popular ECG acquisition method, an advanced method called the Body Surface Potential Map (BSPM) has been deemed more accurate for diagnosing cardiac pathologies [2]. Unfortunately, this technique has not seen widespread clinical use for a number of reasons. One particular reason is that standards for acquiring, storing and visualizing BSPMs are not well defined [3]. This research program will entail the development of a BSPM management system that will address these issues.

The first step in creating a BSPM management system will be to create a format to store BSPM recordings. The format will use the eXtensibe Markup Language (XML) to promote interoperability [4]. This will be the first format of its kind, as currently no format exists for storing BSPMs. The format will be innovative, in that, it will support all possible forms of BSPM multi-electrode configurations [3]. Alongside this format, a web based BSPM viewer will also be developed. This will allow clinicians to visualize and explore BSPM recordings that have been stored using the XML based BSPM format. A number of interactive tools will be included with the BSPM viewer which will enable clinicians to analyze the BSPM and make a diagnosis. In summary, this format and its associated viewer will provide a framework for a complete BSPM management system or a BSPM warehouse. If such a system is made widely available it has the potential to provide BSPM interoperability, knowledge sharing and standardization, hence putting the BSPM in widespread clinical practice.

The HISI funding will be used to support participation in the 35th conference of the International Society for Computerised Electrocardiology, which will be held in Albuquerque, New Mexico on the 21th-25th April 2010 [5]. This is the premier event for this research area and participation will allow me to disseminate my research to experts, who will provide important feedback, along with the potential to establish relationships for future collaborative research. This funding will also support me as a visiting scholar to at least one international institution that has the same research interests. Links have already been established with possible host institutions, which include the Erasmus Medical Centre in Rotterdam and the Scientific Computing and Imaging Institute at the University of Utah in Salt Lake City.

This research will clarify the benefits of BSPMs and provide some practical tools for more productive BSPM research in Ireland. BSPM research is already well established in Ireland [6] and the above activities will increase the impact of this research. With such theoretical acceptance, this practical research will help bring BSPMs to a reality in Ireland.

References

[1] Irish Heart Foundation. (2009, 16/09/09). Facts on heart disease and stroke. 2009(16/09/09), Available: http://www.irishheart.ie/iopen24/facts-heart-disease-stroke-t-7_18.html

[2] M. P. Donnelly, D. D. Finlay, C. D. Nugent and N. D. Black, “Lead selection: old and new methods for locating the most electrocardiogram information,” Journal of Electrocardiology, vol. 41, pp. 257-263, May. 2008.

[3] R. Hoekema, G. J. H. Uijen and A. van Oosterom, “On selecting a body surface mapping procedure,” Journal of Electrocardiology, vol. 32, pp. 93-101, April. 1999.

[4] S. Sfakianakis, C. E. Chronaki, F. Chiarugi, F. Conforti and D. G. Katehakis, “Reflections on the role of open source in health information system interoperability,” Yearb. Med. Inform., pp. 50-60, 2007.

[5] ISCE. (2009, 14/09/09). ISCE – international society for computerized electrocardiology. 2009(14/09/09), Available: http://www.isce.org/

[6] S. J. Maynard, I. B. A. Menown, G. Manoharan, J. Allen, J. McC Anderson and A. A. J. Adgey, “Body surface mapping improves early diagnosis of acute myocardial infarction in patients with chest pain and left bundle branch block,” Br. Med. J., vol. 89, pp. 998-1002, 2003.