title: Use of self-gated radial cardiovascular magnetic resonance to detect and classify arrhythmias (atrial fibrillation and premature ventricular contraction).
abstract: BACKGROUND
  Arrhythmia can significantly alter the image quality of cardiovascular magnetic resonance (CMR); automatic detection and sorting of the most frequent types of arrhythmias during the CMR acquisition could potentially improve image quality. New CMR techniques, such as non-Cartesian CMR, can allow self-gating: from cardiac motion-related signal changes, we can detect cardiac cycles without an electrocardiogram. We can further use this data to obtain a surrogate for RR intervals (valley intervals: VV). Our purpose was to evaluate the feasibility of an automated method for classification of non-arrhythmic (NA) (regular cycles) and arrhythmic patients (A) (irregular cycles), and for sorting of common arrhythmia patterns between atrial fibrillation (AF) and premature ventricular contraction (PVC), using the cardiac motion-related signal obtained during self-gated free-breathing radial cardiac cine CMR with compressed sensing reconstruction (XD-GRASP).
  
  
  METHODS
  One hundred eleven patients underwent cardiac XD-GRASP CMR between October 2015 and February 2016; 33 were included for retrospective analysis with the proposed method (6 AF, 8 PVC, 19 NA; by recent ECG). We analyzed the VV, using pooled statistics (histograms) and sequential analysis (Poincaré plots), including the median (medVV), the weighted mean (meanVV), the total number of VV values (VVval), and the total range (VVTR) and half range (VVHR) of the cumulative frequency distribution of VV, including the median to half range (medVV/VVHR) and the half range to total range (VVHR/VVTR) ratios. We designed a simple algorithm for using the VV results to differentiate A from NA, and AF from PVC.
  
  
  RESULTS
  Between NA and A, meanVV, VVval, VVTR, VVHR, medVV/VVHR and VVHR/VVTR ratios were significantly different (p values = 0.00014, 0.0027, 0.000028, 5×10-9, 0.002, respectively). Between AF and PVC, meanVV, VVval and medVV/VVHR ratio were significantly different (p values = 0.018, 0.007, 0.044, respectively). Using our algorithm, sensitivity, specificity, and accuracy were 93 %, 95 % and 94 % to discriminate between NA and A, and 83 %, 71 %, and 77 % to discriminate between AF and PVC, respectively; areas under the ROC curve were 0.93 and 0.89.
  
  
  CONCLUSIONS
  Our study shows we can reliably detect arrhythmias and differentiate AF from PVC, using self-gated cardiac cine XD-GRASP CMR.
authors.affiliation: Department of Radiology, The Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, 660 First Ave, New York, NY, USA.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA.
authors.forename: Eve
authors.initials: E
authors.lastname: Piekarski
authors.affiliation: Department of Radiology, The Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, 660 First Ave, New York, NY, USA.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA.
authors.forename: Teodora
authors.initials: T
authors.lastname: Chitiboi
authors.affiliation: Department of Radiology, The Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, 660 First Ave, New York, NY, USA.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ramb
authors.affiliation: Department of Radiology, The Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, 660 First Ave, New York, NY, USA.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA.|Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Radiology, The Center for Advanced Imaging Innovation and Research (CAI2R), New York University School of Medicine, 660 First Ave, New York, NY, USA. leon.axel@nyumc.org.|Department of Radiology, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University School of Medicine, New York, NY, USA. leon.axel@nyumc.org.|Sackler Institute of Graduate Biomedical Sciences, New York University School of Medicine, New York, NY, USA. leon.axel@nyumc.org.
authors.forename: Leon
authors.initials: L
authors.lastname: Axel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D019540:Area Under Curve; D001281:Atrial Fibrillation / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055424:Cardiac-Gated Imaging Techniques; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015656:Respiratory Mechanics; D012189:Retrospective Studies; D018879:Ventricular Premature Complexes / Q000145:classification / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055815:Young Adult
keywords: AF; Arrhythmia; Atrial fibrillation; PVC; Premature ventricular contraction; RR intervals; Self-gated CMR; XD-GRASP