Towards personalized clinical in-silico modeling of atrial anatomy and electrophysiology
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SPECIAL ISSUE - ORIGINAL ARTICLE
Towards personalized clinical in-silico modeling of atrial anatomy and electrophysiology Martin W. Krueger • Walther H. W. Schulze • Kawal S. Rhode • Reza Razavi • Gunnar Seemann Olaf Do¨ssel
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Received: 26 April 2012 / Accepted: 26 September 2012 Ó International Federation for Medical and Biological Engineering 2012
Abstract Computational atrial models aid the understanding of pathological mechanisms and therapeutic measures in basic research. The use of biophysical models in a clinical environment requires methods to personalize the anatomy and electrophysiology (EP). Strategies for the automation of model generation and for evaluation are needed. In this manuscript, the current efforts of clinical atrial modeling in the euHeart project are summarized within the context of recent publications in this field. Model-based segmentation methods allow for the automatic generation of ready-to-simulate patient-specific anatomical models. EP models can be adapted to patient groups based on a-priori knowledge and to the individual without significant further data acquisition. ECG and intracardiac data build the basis for excitation personalization. Information from late enhancement (LE) MRI can be used to evaluate the success of radio-frequency ablation (RFA) procedures and interactive virtual atria pave the way for RFA planning. Atrial modeling is currently in a transition from the sole use in basic research to future clinical applications. The proposed methods build the framework for model-based diagnosis and therapy evaluation and planning. Complex models allow to understand biophysical The research leading to these results has received funding from the European Communitys Seventh Framework Programme (FP7/20072013) under grant agreement No. 224495 (euHeart project). M. W. Krueger (&) W. H. W. Schulze G. Seemann O. Do¨ssel Institute of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), Kaiserstr. 12, 76131 Karlsruhe, Germany e-mail: [email protected] K. S. Rhode R. Razavi Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, UK
mechanisms and enable the development of simplified models for clinical applications. Keywords Atrial fibrillation Radio-frequency ablation Biophysical model Model personalization
1 Introduction One of the goals of the euHeart project is the development of techniques for the model-based evaluation and optimization of radio-frequency ablation (RFA) for patients suffering from atrial fibrillation (AF). AF is more and more recognized as a major cost factor in health economics. The prevalence of developing AF increases with age and current therapeutic options cover pharmaceutical therapies as well as curative catheter interventions. In order to gain benefits from model-based therapy planning, it is indispensable to adjust the model to the individual patient. The personalization process always covers the anatomy and electrophysiology in parallel (Fig. 1), as these are strongly interlinked [27]. The
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