Abstract
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Patient-specific computational modeling of the atria can provide a better understanding about mechanisms underlying the arrhythmia and will potentially be used for model-based ablation therapy evaluation and planning. Electrical excitation spreads from the left to the right atrium at discrete locations. The location of the muscular bridges cannot be determined from image data. In the present study, left atrial activation sources were manually identified in local activation time maps of 4 AF patients. This information was used to adjust rule-based placed interatrial bridges in anatomical atrial models of the patients. Sinus rhythm simulations showed a better qualitative agreement to the measured left atrial activation patterns after the adjustment of the bridges. For one patient, the simulated body surface potential (BSP) pattern after the adjustment correlated better to measured BSP maps. The results show that the fusion of intracardiac electrical measurements of early left atrial activation can be used to refine patient atria models with information of the myocardial structure which cannot be imaged. In future, such personalized atrial models may be used to support EP interventions.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Go, A.S., Hylek, E.M., Phillips, K.A., et al.: Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the anticoagulation and risk factors in atrial fibrillation (atria) study. JAMA 285, 2370–2375 (2001)
Calkins, H., Kuck, K.H., Cappato, R., et al.: 2012 hrs/ehra/ecas expert consensus statement on catheter and surgical ablation of atrial fibrillation: recommendations for patient selection, procedural techniques, patient management and follow-up, definitions, endpoints, and research trial design. J. Interv. Card Electrophysiol. 33, 171–257 (2012)
Jacquemet, V., Kappenberger, L., Henriquez, C.S.: Modeling atrial arrhythmias: Impact on clinical diagnosis and therapies. IEEE Rev. Biomed. Eng. 1, 94–114 (2008)
Krueger, M.W., Seemann, G., Rhode, K., et al.: Personalization of atrial anatomy and elelectophysiology as a basis for clinical modeling of radio-frequency-ablation of atrial fibrillation. IEEE Trans. Med. Imag. 32, 73–84 (2013)
Dössel, O., Krueger, M.W., Weber, F.M., et al.: Computational modeling of the human atrial anatomy and electrophysiology. Med. Biol. Eng. Comput. 50, 773–799 (2012)
Ho, S.Y., Sanchez-Quintana, D., Cabrera, J.A., et al.: Anatomy of the left atrium: implications for radiofrequency ablation of atrial fibrillation. J. Cardiovasc. Electr. 10, 1525–1533 (1999)
Platonov, P.G., Mitrofanova, L., Ivanov, V., et al.: Substrates for intra-atrial and interatrial conduction in the atrial septum: anatomical study on 84 human hearts. Heart Rhythm 5, 1189–1195 (2008)
Courtemanche, M., Ramirez, R.J., Nattel, S.: Ionic mechanisms underlying human atrial action potential properties: Insights from a mathematical model. Am. J. Physiol. 275, H301–H321 (1998)
Seemann, G., Sachse, F.B., Karl, M., et al.: Framework for modular, flexible and efficient solving the cardiac bidomain equation using petsc. Mathematics in Industry 15, 363–369 (2010)
McDowell, K.S., Vadakkumpadan, F., Blake, R., et al.: Methodology for patient-specific modeling of atrial fibrosis as a substrate for atrial fibrillation. J. Electrocardiol. (2012)
Rhode, K.S., Hill, D.L.G., Edwards, P.J., et al.: Registration and tracking to integrate x-ray and mr images in an xmr facility. IEEE Trans. Med. Imag. 22, 1369–1378 (2003)
Krueger, M.W., et al.: Modeling atrial fiber orientation in patient-specific geometries: a semi-automatic rule-based approach. In: Metaxas, D.N., Axel, L. (eds.) FIMH 2011. LNCS, vol. 6666, pp. 223–232. Springer, Heidelberg (2011)
Neher, P., Barschdorf, H., Dries, S., Weber, F.M., Krueger, M.W., Dössel, O., Lorenz, C.: Automatic segmentation of cardiac cts - personalized atrial models augmented with electrophysiological structures. In: Metaxas, D.N., Axel, L. (eds.) FIMH 2011. LNCS, vol. 6666, pp. 80–87. Springer, Heidelberg (2011)
Weber, F.M., Luik, A., Schilling, C., et al.: Conduction velocity restitution of the human atrium–an efficient measurement protocol for clinical electrophysiological studies. IEEE Trans. Biomed. Eng. 58, 2648–2655 (2011)
Burdumy, M., Luik, A., Neher, P., et al.: Comparing measured and simulated wave directions in the left atrium - a workflow for model personalization and validation. Biomed. Tech. (Berl.) 57, 79–87 (2012)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Krueger, M.W. et al. (2013). Fusion of Local Activation Time Maps and Image Data to Personalize Anatomical Atrial Models. In: Ourselin, S., Rueckert, D., Smith, N. (eds) Functional Imaging and Modeling of the Heart. FIMH 2013. Lecture Notes in Computer Science, vol 7945. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38899-6_1
Download citation
DOI: https://doi.org/10.1007/978-3-642-38899-6_1
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-38898-9
Online ISBN: 978-3-642-38899-6
eBook Packages: Computer ScienceComputer Science (R0)