Personalization of atrial anatomy and electrophysiology as a basis for clinical modeling of radio-frequency ablation of atrial fibrillation

TY - JOUR

T1 - Personalization of atrial anatomy and electrophysiology as a basis for clinical modeling of radio-frequency ablation of atrial fibrillation

AU - Krueger, Martin W

AU - Seemann, Gunnar

AU - Rhode, Kawal

AU - Keller, D U J

AU - Schilling, Christopher

AU - Arujuna, Aruna

AU - Gill, Jaswinder

AU - O'Neill, Mark D

AU - Razavi, Reza

AU - Dössel, Olaf

PY - 2013/1

Y1 - 2013/1

N2 - Multiscale cardiac modeling has made great advances over the last decade. Highly detailed atrial models were created and used for the investigation of initiation and perpetuation of atrial fibrillation. The next challenge is the use of personalized atrial models in clinical practice. In this study, a framework of simple and robust tools is presented, which enables the generation and validation of patient-specific anatomical and electrophysiological atrial models. Introduction of rule-based atrial fiber orientation produced a realistic excitation sequence and a better correlation to the measured electrocardiograms. Personalization of the global conduction velocity lead to a precise match of the measured P-wave duration. The use of a virtual cohort of nine patient and volunteer models averaged out possible model-specific errors. Intra-atrial excitation conduction was personalized manually from left atrial local activation time maps. Inclusion of LE-MRI data into the simulations revealed possible gaps in ablation lesions. A fast marching level set approach to compute atrial depolarization was extended to incorporate anisotropy and conduction velocity heterogeneities and reproduced the monodomain solution. The presented chain of tools is an important step towards the use of atrial models for the patient-specific AF diagnosis and ablation therapy planing.

AB - Multiscale cardiac modeling has made great advances over the last decade. Highly detailed atrial models were created and used for the investigation of initiation and perpetuation of atrial fibrillation. The next challenge is the use of personalized atrial models in clinical practice. In this study, a framework of simple and robust tools is presented, which enables the generation and validation of patient-specific anatomical and electrophysiological atrial models. Introduction of rule-based atrial fiber orientation produced a realistic excitation sequence and a better correlation to the measured electrocardiograms. Personalization of the global conduction velocity lead to a precise match of the measured P-wave duration. The use of a virtual cohort of nine patient and volunteer models averaged out possible model-specific errors. Intra-atrial excitation conduction was personalized manually from left atrial local activation time maps. Inclusion of LE-MRI data into the simulations revealed possible gaps in ablation lesions. A fast marching level set approach to compute atrial depolarization was extended to incorporate anisotropy and conduction velocity heterogeneities and reproduced the monodomain solution. The presented chain of tools is an important step towards the use of atrial models for the patient-specific AF diagnosis and ablation therapy planing.

KW - Heart

KW - Heart Conduction System

KW - Magnetic Resonance Imaging

KW - Anisotropy

KW - Humans

KW - Models, Cardiovascular

KW - Imaging, Three-Dimensional

KW - Individualized Medicine

KW - Electrocardiography

KW - Atrial Function

KW - Ablation Techniques

KW - Atrial Fibrillation

KW - Heart Atria

U2 - 10.1109/TMI.2012.2201948

DO - 10.1109/TMI.2012.2201948

M3 - Article

C2 - 22665507

SN - 0278-0062

VL - 32

SP - 73

EP - 84

JO - Ieee Transactions on Medical Imaging

JF - Ieee Transactions on Medical Imaging

IS - 1

ER -