Personalization of Atrial Anatomy and Electrophysiology as a Basis for Clinical Modeling of Radio-Frequency Ablation of Atrial Fibrillation
Personalization of Atrial Anatomy and Electrophysiology as a Basis for Clinical Modeling of Radio-Frequency Ablation of Atrial Fibrillation
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DOI：
10.1109/tmi.2012.2201948
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发表时间：
2013-01-01
影响因子：
10.6
通讯作者：
Doessel, Olaf
中科院分区：
文献类型：
--
作者：
Krueger, Martin W.;Seemann, Gunnar;Doessel, Olaf
在过去的十年中，多尺度心脏建模取得了很大的进步。建立了非常详细的心房模型，并用于研究房颤的发生和持续。下一个挑战是在临床实践中使用个性化心房模型。在这项研究中，提出了一个简单而强大的工具框架，它可以生成和验证患者特定的解剖和电生理心房模型。引入基于规则的心房纤维定向产生了逼真的激励序列，并与测得的心电图具有更好的相关性。全局传导速度的个性化导致测量的P波持续时间的精确匹配。使用九个患者和志愿者模型的虚拟队列平均了可能的模型特定误差。根据左心房局部激动时间图手动个性化心房内兴奋传导。将LE-MRI数据纳入模拟显示消融损伤中可能存在间隙。将快速行进水平集方法扩展到心房去极化，将各向异性和传导速度不均匀性纳入其中，并再现了单域解。所提出的工具链是将心房模型用于患者特定AF诊断和消融治疗规划的重要一步。
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.