title: Comparing measured and simulated wave directions in the left atrium - a workflow for model personalization and validation.
abstract: Atrial arrhythmias are frequently treated using catheter ablation during electrophysiological (EP) studies. However, success rates are only moderate and could be improved with the help of personalized simulation models of the atria. In this work, we present a workflow to generate and validate personalized EP simulation models based on routine clinical computed tomography (CT) scans and intracardiac electrograms. From four patient data sets, we created anatomical models from angiographic CT data with an automatic segmentation algorithm. From clinical intracardiac catheter recordings, individual conduction velocities were calculated. In these subject-specific EP models, we simulated different pacing maneuvers and measurements with circular mapping catheters that were applied in the respective patients. This way, normal sinus rhythm and pacing from a coronary sinus catheter were simulated. Wave directions and conduction velocities were quantitatively analyzed in both clinical measurements and simulated data and were compared. On average, the overall difference of wave directions was 15° (8%), and the difference of conduction velocities was 16 cm/s (17%). The method is based on routine clinical measurements and is thus easy to integrate into clinical practice. In the long run, such personalized simulations could therefore assist treatment planning and increase success rates for atrial arrhythmias.
authors.affiliation: Institute of Biomedical Engineering , Karlsruhe Institute of Technology, Karlsruhe, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Burdumy
authors.forename: Armin
authors.initials: A
authors.lastname: Luik
authors.forename: Peter
authors.initials: P
authors.lastname: Neher
authors.forename: Raghed
authors.initials: R
authors.lastname: Hanna
authors.forename: Martin W
authors.initials: MW
authors.lastname: Krueger
authors.forename: Christopher
authors.initials: C
authors.lastname: Schilling
authors.forename: Hans
authors.initials: H
authors.lastname: Barschdorf
authors.forename: Cristian
authors.initials: C
authors.lastname: Lorenz
authors.forename: Gunnar
authors.initials: G
authors.lastname: Seemann
authors.forename: Claus
authors.initials: C
authors.lastname: Schmitt
authors.forename: Olaf
authors.initials: O
authors.lastname: Doessel
authors.forename: Frank M
authors.initials: FM
authors.lastname: Weber
mesh_terms: D000200:Action Potentials; D001281:Atrial Fibrillation / Q000503:physiopathology*; D003198:Computer Simulation; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008953:Models, Anatomic; D008955:Models, Cardiovascular