Development of 3D patient-specific models for left atrium geometric characterization to support ablation in atrial fibrillation patients

2016 
Radiofrequency catheter ablation (RFA) is an important and promising therapy for a trial fibrillation (AF) patients. About 50% of patients present AF recurrence during the first three months of follow-up. Several studies have been performed to assess the relationship between left atrium (LA) volume and AF recurrence following RFA. In fact, a trial enlargement is a consequence of AF and these changes may facilitate the induction of AF. In this study a fully automated approach for LA segmentation with and without pulmonary veins (PVss) from magnetic resonance angiography was implemented and two 3D LA patient-specific models were obtained. LA volumes were compared with volumes from manual segmentation (y=0.92x+4.9, r=0.97, bias=−1.8ml (−2.1%), SD=5.6ml (6.5%), mean percentage difference=−1.8%±7.4%). The developed procedure provides (1) a 3D patient-specific LA model without PVs in order to characterize LA size and (2) a 3D patient specific model including PVs to assist ablation procedure. Future developments of this work include the analysis of the relationship between LA size and RFA success and the use of LA volume as a predictor of AF recurrence.
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