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

Research output: Contribution to journalArticle

Martin W Krueger, Gunnar Seemann, Kawal Rhode, D U J Keller, Christopher Schilling, Aruna Arujuna, Jaswinder Gill, Mark D O'Neill, Reza Razavi, Olaf Dössel

Original languageEnglish
Pages (from-to)73-84
Number of pages12
JournalIeee Transactions on Medical Imaging
Volume32
Issue number1
Early online date30 May 2012
DOIs
E-pub ahead of print30 May 2012
PublishedJan 2013

King's Authors

Abstract

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.

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