Statistical model of paroxysmal atrial fibrillation catheter ablation targets for pulmonary vein isolation

Ahmad Al-Agamy, Rashed Karim, Aruna Arujuna, James L. Harrison, Steven E. Williams, Kawal S. Rhode, Hans C. Van Assen*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingConference paperpeer-review

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia. Pulmonary vein isolation (PVI) by catheter ablation is a cornerstone treatment of paroxysmal AF. Low success rates are mainly due to reconnecting tissue. Local myocardial wall-thickness (WT) information is missing; lesion transmurality is impossible to estimate. WT information can be obtained from pencil beam high-resolution MRI, a timeconsuming protocol. To reduce scan time, automatic selection of regions of interest is proposed. We developed a left atrial target probability model for paroxysmal AF ablation, based on intraprocedural ablation targeting data of fifteen patients, to support the selection of these regions. A common mesh serves as a reference for registration of the electroanatomical meshes and ablation targets using landmark registration and the Iterative Closest Points algorithm. This is followed by projection of the ablation targets onto the mean mesh model, closure of isolated ablation voids on the surface and Gaussian smoothing of the probability distribution. The final probability distribution clearly shows PVI contours as suggested in the consensus statement by European associations. The right inferior pulmonary vein (RIPV) shows a lower ablation probability, which may be due to limited maneuverability of the ablation catheter and the proximity of the RIPV ostium and the transseptal puncture, where the catheter enters the left atrium.

Original languageEnglish
Title of host publicationLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
PublisherSpringer-Verlag Berlin Heidelberg
Pages221-230
Number of pages10
Volume8896
ISBN (Print)9783319146775
DOIs
Publication statusPublished - 2015
Event5th International Workshop on Statistical Atlases and Computational Models of the Heart, STACOM 2014 Held in Conjunction with Medical Image Computing and Computer Assisted Intervention Conference, MICCAI 2014 - Boston, United States
Duration: 18 Sept 201418 Sept 2014

Publication series

NameLecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)
Volume8896
ISSN (Print)03029743
ISSN (Electronic)16113349

Conference

Conference5th International Workshop on Statistical Atlases and Computational Models of the Heart, STACOM 2014 Held in Conjunction with Medical Image Computing and Computer Assisted Intervention Conference, MICCAI 2014
Country/TerritoryUnited States
CityBoston
Period18/09/201418/09/2014

Keywords

  • Atrial fibrillation
  • Catheter ablation
  • Left atrium
  • Pulmonary vein isolation
  • Statistical modelling

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