On the 22nd of February, the second General Assembly of cvREMOD Project was held at Universtitat Pompeu Fabra, Barcelona. During the meeting, the results of the year 2011 were shared among all the partners. These results will be a preparation for the annual project review that is planned for April 2012.
cvREMOD is a project funded by the CDTI Spanish public center and nine private national companies, led by Grupo Hospitalario Quirón. The main goal of the project is to provide new diagnostic techniques for the prevention and treatment of cardiovascular diseases, which is one of the most common causes of death in the world today. During last year of the project, several clinical prototypes developed using GIMIAS framework will be validated by clinicians in a clinical environment.
During the general assembly, there was a space dedicated to show the different demonstrators that are being developed in the project. The GIMIAS team showed a demo of GIMIAS using grid computing execution and remote file storage. For this demo, two plugins that are being developed in the context of this project were used: Unicore Plugin, for grid computing execution, and XNAT Plugin, for accessing remote data files stored in XNAT server.
The demo was showing a specific practical use case: Generation of anatomical atlas of the heart. This use case requires high computation resources because a number of images in the order of 50 or above need to be processed. The use case can be summarized into the following steps:
Notice that for this use case, the images of the patients are downloaded directly from XNAT to Unicore server. This optimizes the time for transferring the data. To achieve this, GIMIAS was integrated with Unicore on the grid. Unicore executes GIMIAS with the user authentication parameters that allow connecting to XNAT.
Another successful result of the cvREMOD project is the testing of GIMIAS as a support tool during minimally invasive surgery of Ventricular Tachycardia (VT) disease at the Hospital Clínic of Barcelona.
VT refers to any heart rhythm faster than 100-120 beats per minute and, with some exceptions, it is associated with an increased risk of sudden cardiac death .
Catheter ablation is a therapeutic option that is indicated for many patients with recurrent VT late after myocardial infarction. Currently the identification of ablation target sites relies on electroanatomical voltage mapping (EAM). However the integration of the information obtained with cardiac imaging techniques (in particular, contrast-enhanced magnetic resonance imaging (CE-MRI)) with EAM may help to plan and guide the ablation procedure.
In order to support the electrophysiologist in the identification of the ablation target sites, a new prototype has been developed in GIMIAS: VT Planning. This prototype allows creating a model of the ventricle from the patient’s medical image before the intervention, thus allowing the electrophysiologist to select the patients who are most likely to suffer from VT and carefully plan the ablation procedure.
In addition, the visualization of the patient specific model can support the electrophysiologist during the intervention: a monitor is placed inside the operation room and the model of the patient’s heart is displayed. The accurate localization of the ablation target sites on the patient specific model, in conjunction with the EAM, could help guiding the ablation procedure, thus making it shorter and more effective.
 S J Compton, Ventricular Tachycardia, http://reference.medscape.com/
 AP Wijnmaalen, RJ van der Geest, C F.B. van Huls van Taxis, H-M J. Siebelink, LJM Kroft, JJ Bax, JHC Reiber, MJ Schalij,K Zeppenfeld, Head-to-head comparison of contrast-enhanced magnetic resonance imaging and electroanatomical voltage mapping to assess post-infarct scar characteristics in patients with ventricular tachycardias: real-time image integration and reversed registration, EHJ (2011) 32, 104–114