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

Background: Ventricular electrical dyssynchrony can be examined using ultra-high-frequency (UHF-ECG) analysis. Furthermore, UHF-ECG analysis would allow direct optimization of pacing therapy. Here we introduce VDI Vision (Ventricular Dyssynchrony Imaging), a desktop application for the real-time processing of UHFECG recordings. Method: Incoming ECG data (5kHz, 26 bits, 24 channels) are processed as follows: QRS detection, pacemaker stimuli elimination, QRS clustering, amplitude envelopes in nine frequency bands, and final combination into the Ventricular Depolarization (VD) map. The VD map is updated whenever a new QRS is detected. Results: We developed the VDI vision using the .NET platform. Until the end of March 2021, the VDI-monitor was used to analyze 773 and 4,849 recordings at ICRCFNUSA 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). Conclusion: The VDI vision delivers information about electrical ventricular dyssynchrony in real-time. The instant analysis allows using the software during implant procedures for optimizing electrode placement and pacing. The presented real-time solution also significantly minimized measurement duration.