Three-dimensional atrial wall thickness maps to inform catheter ablation procedures for atrial fibrillation
Three-dimensional atrial wall thickness maps to inform catheter ablation procedures for atrial fibrillation
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DOI：
10.1093/europace/euv073
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发表时间：
2016-03-01
期刊：
影响因子：
6.1
通讯作者：
Niederer, Steven
中科院分区：
文献类型：
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作者：
Bishop, Martin;Rajani, Ronak;Niederer, Steven
心房壁损伤的形成是房颤消融成功的关键，并取决于左心房壁厚度（LAWT）。为了计算LAWT，在从分割的计算机断层扫描血管造影（CTA）数据集导出的左心房有限元网格上求解拉普拉斯方程。然后根据从心内膜或心外膜跨越壁的拉普拉斯解导出的场线长度计算局部LAWT。该方法在心房体模上进行了验证，并回顾性地应用于在我们研究所接受常规冠状动脉CTA的标准临床适应症的10例患者。在左心房体模上验证了拉普拉斯壁厚算法。对于0.5-5.0 mm的厚度，壁厚测量的误差< 0.2 mm，这归因于图像分辨率和分割伪影。对10例患者进行了左心房壁厚度测量。在所有患者中，从冠状动脉CTA图像成功生成了全面LAWT标测图。平均LAWT测量范围为0.6至1.0 mm，显示出显著的患者间和患者内变异性。左心房壁厚度可以使用左心房有限元网格上的拉普拉斯方程的解在整个左心房上稳健有效地测量。进一步的研究表明，LAWT标测图整合到现有的3D解剖标测系统中是否可以为指导射频消融提供重要的解剖信息。
Transmural lesion formation is critical to success in atrial fibrillation ablation and is dependent on left atrial wall thickness (LAWT). Pre- and peri-procedural planning may benefit from LAWT measurements.To calculate the LAWT, the Laplace equation was solved over a finite element mesh of the left atrium derived from the segmented computed tomographic angiography (CTA) dataset. Local LAWT was then calculated from the length of field lines derived from the Laplace solution that spanned the wall from the endocardium or epicardium. The method was validated on an atrium phantom and retrospectively applied to 10 patients who underwent routine coronary CTA for standard clinical indications at our institute. The Laplace wall thickness algorithm was validated on the left atrium phantom. Wall thickness measurements had errors of < 0.2 mm for thicknesses of 0.5-5.0 mm that are attributed to image resolution and segmentation artefacts. Left atrial wall thickness measurements were performed on 10 patients. Successful comprehensive LAWT maps were generated in all patients from the coronary CTA images. Mean LAWT measurements ranged from 0.6 to 1.0 mm and showed significant inter and intra patient variability.Left atrial wall thickness can be measured robustly and efficiently across the whole left atrium using a solution of the Laplace equation over a finite element mesh of the left atrium. Further studies are indicated to determine whether the integration of LAWT maps into pre-existing 3D anatomical mapping systems may provide important anatomical information for guiding radiofrequency ablation.