论文标题
患者特异性心脏模型朝着心房纤颤
Patient-Specific Heart Model Towards Atrial Fibrillation
论文作者
论文摘要
心房颤动是一种心律障碍,影响了全球数千万人。最有效的治疗方法是导管消融。这涉及到电解映射促进的异常心脏组织的不可逆转加热。但是,很难始终如一地识别由于其混乱行为而可能引发或永久触发房颤的触发因素和来源。我们开发了一种特定于患者的计算心脏模型,该模型可以准确地重现激活模式,以帮助定位这些触发器和来源。我们的模型具有较高的空间分辨率,具有全元时间同步活性,并且具有患者特异性精确的电生理激活模式。总共处理了15例患者数据:窦性节奏中有8例,心房颤动中有6例,心动过速1例。对于分辨率,平均模拟几何体素体素是2.47毫米长的立方体。对于同步,该模型会吸收约1,500个局部电解记录,最佳地拟合参数与个体的中庭几何形状,然后生成全元激活模式。为了准确性,窦性节奏的平均局部激活时间误差为5.47毫秒,颤动和心动过速为10.97 ms。鼻窦节奏的平均相关性为0.95,颤动和心动过速为0.81。这一有希望的结果表明,我们的模型是捕获更复杂的节奏(例如房颤)的有效构件,以指导医生有效消融疗法。
Atrial fibrillation is a heart rhythm disorder that affects tens of millions people worldwide. The most effective treatment is catheter ablation. This involves irreversible heating of abnormal cardiac tissue facilitated by electroanatomical mapping. However, it is difficult to consistently identify the triggers and sources that may initiate or perpetuate atrial fibrillation due to its chaotic behavior. We developed a patient-specific computational heart model that can accurately reproduce the activation patterns to help in localizing these triggers and sources. Our model has high spatial resolution, with whole-atrium temporal synchronous activity, and has patient-specific accurate electrophysiological activation patterns. A total of 15 patients data were processed: 8 in sinus rhythm, 6 in atrial flutter and 1 in atrial tachycardia. For resolution, the average simulation geometry voxel is a cube of 2.47 mm length. For synchrony, the model takes in about 1,500 local electrogram recordings, optimally fits parameters to the individual's atrium geometry and then generates whole-atrium activation patterns. For accuracy, the average local activation time error is 5.47 ms for sinus rhythm, 10.97 ms for flutter and tachycardia; and the average correlation is 0.95 for sinus rhythm, 0.81 for flutter and tachycardia. This promising result demonstrates our model is an effective building block in capturing more complex rhythms such as atrial fibrillation to guide physicians for effective ablation therapy.