Novel method for comparison of pre-planned ablation lines for treatment of atrial fibrillation using a common reference model

Abstract

The standard approach in interventional treatment of atrial fibrillation (AFib) is pulmonary vein isolation (PVI). PVI can be achieved by placing radio-frequency (RF) lesions contiguously around the pulmonary veins attached to the left atrium. Since accurate lesion placement may be difficult, pre-planned ablation lines can be used for better navigation both when using mapping systems or also when relying on fluoro overlay techniques. By working with physicians in this field, we learned that clinically acceptable ablation lines are not necessarily limited to a unique line, but there appears to be some flexibility when defining regions within which ablation should be performed.We present a novel method to investigate the dimensions of such a region based on comparing pre-planned ablation lines set up for different left atria. A common reference model is proposed as a means to combine and compare different pre-planned ablation lines. Based on our data, we found an average deviation of individually pre-planned ablation lines from their respective mean of 2.9±1.9 mm and 1.8±1.5 mm for right and left sided ipsilateral planning lines, respectively. Beyond ablation line assessment, this work also introduces a framework which can be extended to automatic pre-planning of ablation lines for PVI procedures.Index Terms-atrial fibrillation, ablation line planning, shape modeling and analysis, pulmonary vein isolation,

Performance assessment of displacement-field estimation of the human left atrium from 4D-CT images using the coherent point drift algorithm

“…Furthermore, the estimated LA deformation characteristics with local anisotropy were consistent with existing clinical observations. These results highlight performances and validities of the CPD-based workflow to estimate global LA displacement fields consistent with the LA surface deformation extracted from 4D-CT images.This achievement can reinforce validities of existing studies [20,22] and help readers conduct the LA deformation estimation and analysis smoothly. Furthermore, assessments of influences of each hyperparameter on LA displacement estimation illustrated these parameter sensitivities and current limitations of the approach conducted.…”

“…Given these practically useful properties of CPD, a few existing studies have attempted to apply CPD to LA displacement-field estimation [20,21,22]. In our previous study, we used CPD to estimate subject-specific LA displacement fields over a cardiac cycle from 4D-CT images and proposed to use this LA displacement field as a moving-wall boundary condition in computational LA blood flow analysis [22].…”

Automatic planning of atrial fibrillation ablation lines using landmark-constrained nonrigid registration

“…We also applied the method proposed in Ref. 18 to our current test dataset using nonrigid point cloud registration not involving any landmarks. This method only achieved an average planning error of 9.7 AE 7.0 mm over all datasets, indicating that the use of landmark constraints offers significant improvements in registration performance.…”