Electrocardiographic imaging (ECGI)  is a non-invasive technique to describe intracardiac depolarization and repolarization. Commercial tools are available to describe these patterns for the epicardium. Unfortunately, these tools lack precision in clinical practice. Recently, ECGi has become of interest to more precisely non-invasively study depolarization and repolarization sequences in patients with inherited cardiomyopathies and patient who were resuscitated from sudden cardiac death. To adequately use ECGi in clinical practice several research groups are working to improve the ECGi technique. We propose the formation of an ECGi working group to boost the progress of this technique and to improve collaboration between the different research groups in the Netherlands. 

List of members: 

  • Amsterdam UMC: Ruben Coronel, Veronique Meijborg,  Mario Götte, Pranav Bhagirath, Pieter Postema, Machteld Boonstra 
  • Maastricht UMC: Matthijs Cluitmans, Job Stoks, Uyen Nguyen, Karin Smits
  • Maastricht University: Joel Karel, Ralf Peeters
  • PEACS: Peter van Dam 
  • Radboud Universiteit: Thom Oostendorp 
  • UMC Utrecht: Peter Loh, Rutger Hassink, Rob Roudijk, Manon Kloosterman, Iris van der Schaaf, Lisa Verheul, Diantha Schipaanboord

Goals:

  1. Collaboration
  2. Knowledge exchange
  3. Data exchange
  4. Coordinated research projects
  5. Consensus in electrode set-ups and cardiac source models
  6. Establish a joint national collaborative project


Meetings
:

  1. November 2020
  2. March 2021
  3. September 2022
  4. December 2022
  5. June 2023 – cancelled

Achieved goals:

  1. Collaboration – There has been a lot of collaborations between members of the ECGi working group which has resulted in different publications (e.g. van der Waal et al., Boonstra et al., Roudijk et al. and Cluitmans et al.)
  2. Sharing knowledge – Knowledge is shared during the ECGi meetings. By meeting all researchers in the field of ECGi, researchers can contact each other more easily.
  3. Data exchange – Data was shared to investigate the differences in electrode set-ups.
  4. Coordinated research projects – All researchers of the ECGi working group are working in a different research area. Current work and the results of all projects are presented during the ECGi meetings.
  5. Consensus in electrode set-ups and cardiac source models – Research into the electrode positions and set-up was conducted but has not yet been published. Research was conducted to investigate the differences between the epicardial potential model and the equivalent dipole layer model. A theoretical comparison was made by Jeanne van der Waal and her colleagues where they discussed the similarities and differences in applicability, strengths and weaknesses and sketch a road towards improved inverse solutions by a combination of two methods: “Noninvasive inverse electrocardiography: a theoretical comparison between two cardiac source models”. They also compared the reconstruction accuracy of the EP method with that of the EDL method for both the activation and repolarization timings and pacing localization error: “Direct comparison of the performance of two source models for electrocardiographic imaging of activation and repolarization”. Both articles are in preparation and can be found in the thesis of Jeanne van der Waal.
  6. To establish a joint national collaborative project – A joint national collaborative project was designed during several meetings with a selection of the members of the ECGi working group. A proposal was written and submitted. Unfortunately, a grant was not awarded. A special agency was asked to help with the submission but there were no resources to pay the agency.

Plans next 3 years

The ECGi working group engaged in an intense collaboration during the design of the national collaborative project. A proposal was submitted, but, unfortunately, the grant was not awarded. In combination with the pandemic and the replacement of the previous PhD’ers, the ECGi working group became less active. We would like to reactivate the ECGi working group with the current (new) PhD’ers and clinicians interested in the field of ECGi. This is very important since there are only a few ECGi researchers in the Netherlands.

Goals:

  1. Collaboration
  2. Knowledge exchange
  3. Data exchange
  4. Coordinated research projects
  5. Consensus in electrode set-ups and cardiac source models
  6. To establish a joint national collaborative project – The old proposal will be discussed again in the ECGi working group. When consent is reached, a new, updated version will be submitted. We will look into the possible resources to fund the writing and submission of this project. We will also contact the Netherlands Heart Institute to facilitate this collaborative project.

Planned activities:

  • October (19) 2023: Hybrid ECGi meeting + dinner
  • December 2023: Hybrid ECGi meeting
  • February 2024 Meeting with the EP working group, topic: “mechanisms and imaging of arrhythmias”
  • April 2024: Hybrid ECGi meeting + dinner

Objectives:

The ECGi working group will focus on collaboration, knowledge exchange and coordination of the individual research projects. In a joint national collaborative project, all Dutch experts in the field of ECGi will work together on a multidimensional project.

During meetings the working group will focus on:

  • Collaboration
  • Knowledge exchange
  • Data exchange
  • Coordination of the research projects
  • Consensus in electrode set-iups and cardiac source models
  • Establish a joint national collaborative project.

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