Cargando…

In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology

We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasi...

Descripción completa

Detalles Bibliográficos
Autores principales: Lim, Byounghyun, Kim, Jaehyeok, Hwang, Minki, Song, Jun-Seop, Lee, Jung Ki, Yu, Hee-Tae, Kim, Tae-Hoon, Uhm, Jae-Sun, Joung, Boyoung, Lee, Moon-Hyung, Pak, Hui-Nam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016008/
https://www.ncbi.nlm.nih.gov/pubmed/32051487
http://dx.doi.org/10.1038/s41598-020-59372-x
_version_ 1783496902085443584
author Lim, Byounghyun
Kim, Jaehyeok
Hwang, Minki
Song, Jun-Seop
Lee, Jung Ki
Yu, Hee-Tae
Kim, Tae-Hoon
Uhm, Jae-Sun
Joung, Boyoung
Lee, Moon-Hyung
Pak, Hui-Nam
author_facet Lim, Byounghyun
Kim, Jaehyeok
Hwang, Minki
Song, Jun-Seop
Lee, Jung Ki
Yu, Hee-Tae
Kim, Tae-Hoon
Uhm, Jae-Sun
Joung, Boyoung
Lee, Moon-Hyung
Pak, Hui-Nam
author_sort Lim, Byounghyun
collection PubMed
description We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasibility. We acquired > 500 endocardial bipolar electrograms during right atrial pacing at the beginning of the AF ablation procedures. Based on the clinical bipolar electrograms, we generated simulated voltage maps by applying fibrosis and local activation maps adjusted for the fiber orientation. The software’s accuracy (CUVIA2.5) was retrospectively tested in 17 patients and feasibility prospectively in 10 during clinical AF ablation. Results: We found excellent correlations between the clinical and simulated voltage maps (R = 0.933, p < 0.001) and clinical and virtual local conduction (R = 0.958, p < 0.001). The proportion of virtual local fibrosis was 15.4, 22.2, and 36.9% in the paroxysmal AF, persistent AF, and post-pulmonary vein isolation (PVI) states, respectively. The reconstructed virtual bipolar electrogram exhibited a relatively good similarities of morphology to the local clinical bipolar electrogram (R = 0.60 ± 0.08, p < 0.001). Feasibility testing revealed an in situ procedural computing time from the clinical data acquisition to wave-dynamics analyses of 48.2 ± 4.9 min. All virtual analyses were successfully achieved during clinical PVI procedures. We developed a highly efficient, realistic, in situ procedural simulation model reflective of individual anatomy, fiber orientation, fibrosis, and electrophysiology that can be applied during AF ablation.
format Online
Article
Text
id pubmed-7016008
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Nature Publishing Group UK
record_format MEDLINE/PubMed
spelling pubmed-70160082020-02-21 In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology Lim, Byounghyun Kim, Jaehyeok Hwang, Minki Song, Jun-Seop Lee, Jung Ki Yu, Hee-Tae Kim, Tae-Hoon Uhm, Jae-Sun Joung, Boyoung Lee, Moon-Hyung Pak, Hui-Nam Sci Rep Article We previously reported the feasibility and efficacy of a simulation-guided clinical catheter ablation of atrial fibrillation (AF) in an in-silico AF model. We developed a highly efficient realistic AF model reflecting the patient endocardial voltage and local conduction and tested its clinical feasibility. We acquired > 500 endocardial bipolar electrograms during right atrial pacing at the beginning of the AF ablation procedures. Based on the clinical bipolar electrograms, we generated simulated voltage maps by applying fibrosis and local activation maps adjusted for the fiber orientation. The software’s accuracy (CUVIA2.5) was retrospectively tested in 17 patients and feasibility prospectively in 10 during clinical AF ablation. Results: We found excellent correlations between the clinical and simulated voltage maps (R = 0.933, p < 0.001) and clinical and virtual local conduction (R = 0.958, p < 0.001). The proportion of virtual local fibrosis was 15.4, 22.2, and 36.9% in the paroxysmal AF, persistent AF, and post-pulmonary vein isolation (PVI) states, respectively. The reconstructed virtual bipolar electrogram exhibited a relatively good similarities of morphology to the local clinical bipolar electrogram (R = 0.60 ± 0.08, p < 0.001). Feasibility testing revealed an in situ procedural computing time from the clinical data acquisition to wave-dynamics analyses of 48.2 ± 4.9 min. All virtual analyses were successfully achieved during clinical PVI procedures. We developed a highly efficient, realistic, in situ procedural simulation model reflective of individual anatomy, fiber orientation, fibrosis, and electrophysiology that can be applied during AF ablation. Nature Publishing Group UK 2020-02-12 /pmc/articles/PMC7016008/ /pubmed/32051487 http://dx.doi.org/10.1038/s41598-020-59372-x Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Lim, Byounghyun
Kim, Jaehyeok
Hwang, Minki
Song, Jun-Seop
Lee, Jung Ki
Yu, Hee-Tae
Kim, Tae-Hoon
Uhm, Jae-Sun
Joung, Boyoung
Lee, Moon-Hyung
Pak, Hui-Nam
In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title_full In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title_fullStr In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title_full_unstemmed In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title_short In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
title_sort in situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7016008/
https://www.ncbi.nlm.nih.gov/pubmed/32051487
http://dx.doi.org/10.1038/s41598-020-59372-x
work_keys_str_mv AT limbyounghyun insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT kimjaehyeok insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT hwangminki insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT songjunseop insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT leejungki insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT yuheetae insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT kimtaehoon insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT uhmjaesun insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT joungboyoung insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT leemoonhyung insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology
AT pakhuinam insituprocedureforhighefficiencycomputationalmodelingofatrialfibrillationreflectingpersonalanatomyfiberorientationfibrosisandelectrophysiology