Burdumy Michael, Luik Armin, Neher Peter, Hanna Raghed, Krueger Martin W, Schilling Christopher, Barschdorf Hans, Lorenz Cristian, Seemann Gunnar, Schmitt Claus, Doessel Olaf, Weber Frank M
Institute of Biomedical Engineering , Karlsruhe Institute of Technology, Karlsruhe, Germany.
Biomed Tech (Berl). 2012 Feb 22;57(2):79-87. doi: 10.1515/bmt-2011-0059.
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.
在电生理（EP）研究期间，心房心律失常常采用导管消融治疗。然而，成功率仅处于中等水平，借助个性化的心房模拟模型可能会有所提高。在这项工作中，我们展示了一种基于常规临床计算机断层扫描（CT）和心内电图来生成和验证个性化EP模拟模型的工作流程。从四个患者数据集出发，我们使用自动分割算法从血管造影CT数据创建了解剖模型。从临床心内导管记录中计算出个体传导速度。在这些特定于个体的EP模型中，我们模拟了在相应患者中应用环形标测导管进行的不同起搏操作和测量。通过这种方式，模拟了正常窦性心律以及冠状窦导管起搏。对临床测量数据和模拟数据中的波向和传导速度进行了定量分析并进行比较。平均而言，波向的总体差异为15°（8%），传导速度的差异为16 cm/s（17%）。该方法基于常规临床测量，因此易于融入临床实践。从长远来看，这种个性化模拟因此可以辅助治疗规划并提高心房心律失常的成功率。
