Predicting Atrial Fibrillation Mechanisms Through Deep Learning

心房颤动（AF）是最常见的心律失常，仅在英国就影响超过110万人，并且与其他心血管疾病、中风和死亡的风险增加有关。对药物治疗无反应的患者可以使用射频导管消融治疗，其用于隔离导致AF的病理组织区域。AF患者需要不同的治疗量：一些患者需要多次手术，采用更广泛的消融策略;而对于其他患者，使用射频导管消融进行更简单的肺静脉隔离就足够了。预测消融治疗方法是否足以治疗特定患者是一项临床挑战，如果能够解决，可以提高消融手术的安全性，并减少这些手术的时间和成本。针对患者属性（包括心脏成像和电气数据）进行个性化的计算生物物理模拟，可以提供对AF及其治疗方法的实质性见解，但是运行太慢而不能在临床过程中使用。我的目标是开发一种结合生物物理模拟和机器学习的网络管道，可以准确量化单个患者消融治疗成功的可能性，以便在临床手术中使用，以指导消融治疗。机器学习网络将接受大量生物物理模拟数据的训练，以确保它正确捕获系统的物理和生理学。然后，训练将随着临床数据的复杂性和真实性而增强。最后，深度学习管道将在回顾性研究中进行测试。我们希望这项研究将为这种预测管道提供概念验证。我们的新方法有可能通过构建一个管道来彻底改变AF的预测建模领域，该管道使患者特定的治疗方法能够在单次消融手术中开发和应用。我们希望在未来，临床和研究中心将能够使用经过训练的机器学习网络来预测个体患者中导致AF的因素以及不同消融手术的结果。这可能会提高消融手术的安全性，更好地选择患者，以及减少这些手术的时间和成本。

Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting over 1.1 million people in the UK alone, and is associated with increased risk of other cardiovascular disease, stroke and death. Patients who do not respond to drug treatment may be treated using radio frequency catheter ablation therapy, which is used to isolate the areas of pathological tissue responsible for AF. AF patients require different amounts of treatment: some patients require multiple procedures, with more extensive ablation strategies; while for others, a more simple isolation of the pulmonary veins using radio frequency catheter ablation is sufficient. Predicting whether an ablation treatment approach is a sufficient treatment for a particular patient is a clinical challenge, which if solved could improve safety of ablation procedures, and decrease time and cost for these procedures.Computational biophysical simulations personalised to patient properties, including cardiac imaging and electrical data, may offer substantial insights into AF and how to treat it, but run too slowly to be used during clinical procedures. My objective is to develop a combined biophysical simulation and machine-learning network pipeline that accurately quantifies the likelihood of success of ablation therapies for an individual patient quickly enough for use during a clinical procedure, to guide ablation therapy. The machine-learning network will be trained to large quantities of biophysical simulated data to ensure that it correctly captures the physics and physiology of the system. The training will then be augmented with the complexity and reality of clinical data. Finally, the deep learning pipeline will be tested in a retrospective study.We hope that this study will provide a proof of concept for this predictive pipeline. Our novel approach has the potential to revolutionise the field of predictive modelling for AF by constructing a pipeline that enables patient-specific treatment approaches to be developed and applied during a single ablation procedure. We hope that in the future, clinical and research centres will be able to use the trained machine learning network to predict the factors responsible for AF in an individual patient and the outcome of different ablation procedures. This may lead to improved safety of ablation procedures, better patient selection, as well as decreased time and cost for these procedures.