A Web-based tool for processing and visualizing body surface potential maps

Abstract

The body surface potential map (BSPM) is potentially more accurate for diagnosing cardiac pathologies when compared to the standard 12-lead electrocardiogram (ECG). However, a contributing factor to the lack of widespread adoption of the BSPM is the shortage of standard methods for its storage and visualization. Based on these observations, a BSPM storage format based on the eXtensible Markup Language has been developed within this study, alongside a Web-based BSPM viewer. This viewer was created using a lossless vector graphics tool (Adobe Flash) to maintain the quality of the ECG waveforms when they are enlarged. The viewer also runs inside the Web browser to facilitate BSPM visualization independent of the clinician's geographical location. This online nature enabled the creation of a comments system that can be used to assist in a collaborative diagnosis. This is useful because BSPM diagnostic criteria are not well established. Moreover, using the viewer's innovative tools (ie, calipers, isopotential maps), the clinician can explore BSPM datasets. Algorithms have also been integrated within the system to extract and display the 12-lead ECG and the vectorcardiogram from the BSPM. This viewer has been available online for 10 months alongside a Weblog, which has been used to record the user's feedback. During this period, 12 experts from both the clinical and visualization domains evaluated the viewer and contributed to its design. It has been the general consensus of all experts that the application is an effective solution for visualizing BSPMs. This viewer has been tested to visualize 2 different BSPMs using a PC (3 GHz CPU, 3 GB RAM, 6 MB broadband). The Lux-192 BSPM and the Kornreich-117 BSPM where both uploaded and visualized within 3.8 seconds (mean time from 10 trials). This BSPM storage format and its associated viewer provide a framework for a BSPM management system. If this system is made widely available, it has the potential to provide BSPM interoperability, knowledge sharing, and standardization. This has the potential to increase the uptake of BSPM integration into routine clinical practice.