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

A.O.E. Alagamy, R. Karim, A. Arujuna, J.L. Harrison, S.E. Williams, K.S. Rhode, H.C. Assen, van

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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 time-consuming 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 publicationStatistical Atlases and Computational Models of the Heart - Imaging and Modelling Challenges. 5th International Workshop, STACOM 2014, Held in Conjunction with MICCAI 2014, Boston, MA, USA, September 18, 2014, Revised Selected Papers
EditorsO. Camara, T. Mansi, M. Pop, K. Rhode, M. Sermesant, A. Young
PublisherSpringer
Pages221-230
ISBN (Print)978-3-319-14677-5
DOIs
Publication statusPublished - 2015
Event5th International Workshop on Statistical Atlases and Computational Models of the Heart (STACOM 2014), September 18, 2014, Boston, MA, USA - Boston, MA, United States
Duration: 18 Sep 201418 Sep 2014

Publication series

NameLecture Notes in Computer Science
Volume8896
ISSN (Print)0302-9743

Workshop

Workshop5th International Workshop on Statistical Atlases and Computational Models of the Heart (STACOM 2014), September 18, 2014, Boston, MA, USA
Abbreviated titleSTACOM 2014
CountryUnited States
CityBoston, MA
Period18/09/1418/09/14
OtherWorkshop held in conjunction with the 17th International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI 2014)

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    Alagamy, A. O. E., Karim, R., Arujuna, A., Harrison, J. L., Williams, S. E., Rhode, K. S., & Assen, van, H. C. (2015). Statistical model of paroxysmal atrial fibrillation catheter ablation targets for pulmonary vein isolation. In O. Camara, T. Mansi, M. Pop, K. Rhode, M. Sermesant, & A. Young (Eds.), Statistical Atlases and Computational Models of the Heart - Imaging and Modelling Challenges. 5th International Workshop, STACOM 2014, Held in Conjunction with MICCAI 2014, Boston, MA, USA, September 18, 2014, Revised Selected Papers (pp. 221-230). (Lecture Notes in Computer Science; Vol. 8896). Springer. https://doi.org/10.1007/978-3-319-14678-2 23, https://doi.org/10.1007/978-3-319-14678-2_23