Identifies areas of interest associated with atrial fibrillation recurrences.
Atrial fibrillation (AF) is the most common heart rhythm disorder characterized by irregular and often rapid heartbeat. In AF, the heart's upper chambers (atria) beat chaotically and don't effectively push blood into the lower chambers (ventricles). This can lead to symptoms like palpitations, shortness of breath, and fatigue. AF causes about 1 in 7 strokes. Treatment options include medications, lifestyle changes, and procedures, such as catheter ablation (CA), to restore normal heart rhythm. CA is the most common strategy for AF treatment but has a recurrence rate of 20 to 40% within one year. Presently, prognostic models have demonstrated promise in foreseeing the likelihood of AF recurrence following CA. However, these models only offer moderate predictive accuracy, and no model has conclusively outperformed the rest. Thus, there are currently no imaging markers present to reliably predict the risk or the sites associated with recurrence (SAR) of AF after ablation (AF+). As a result, there is a crucial clinical need to develop a precise and practical model that can widely and reliably predict AF recurrence risk in patients post-CA.
Researchers at Emory developed a parallel multimodal approach to simultaneously construct atlases on both CT and MRI scans. These atlases were then used to identify SARs and evaluate the agreement in identified regions across the two different modalities. Using a deformable registration-based method, researchers identified shape differences of the left atrium (LA) as predicting the recurrence of AF after catheter ablation by registering AF+ and AF-. Moreover, this identification was corroborated between CT and MRI derived atlases. Based on the assumption that shape of the LA may be associated with recurrence, two atlases were derived for AF+ and AF- via registering each patient with a template. Then the regions showing statistically significant differences between AF+ and AF- were determined. Proper identification of SARs for AF from CT and MRI scans can be used to assist in the selection of region for catheter ablation targeting.
Proof of concept has been established by deriving atlases from two different sets of patient cohorts.