Abstract
Non-invasive prediction of optimal targets for efficient radio-frequency ablation is a major challenge in the treatment of ventricular tachycardia. Most of the related modelling work relies on magnetic resonance imaging of the heart for patient-specific personalized electrophysiology simulations.
In this study, we used high-resolution computed tomography images to personalize an Eikonal model of cardiac electrophysiology in seven patients, addressed to us for catheter ablation in the context of post-infarction arrhythmia. We took advantage of the detailed geometry offered by such images, which are also more easily available in clinical practice, to estimate a conduction speed parameter based on myocardial wall thickness. We used this model to simulate a propagation directly on voxel data, in similar conditions to the ones invasively observed during the ablation procedure.
We then compared the results of our simulations to dense activation maps that recorded ventricular tachycardias during the procedures. We showed as a proof of concept that realistic re-entrant pathways responsible for ventricular tachycardia can be reproduced using our framework, directly from imaging data.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Mozaffarian, D., Benjamin, E.J., Go, A.S., Arnett, D.K., Blaha, M.J., Cushman, M., Das, S.R., de Ferranti, S., Després, J.-P., Fullerton, H.J., et al.: Executive summary: heart disease and stroke statistics-2016 update: a report from the american heart association. Circulation 133(4), 447 (2016)
Ghanbari, H., Baser, K., Yokokawa, M., Stevenson, W., Bella, P.D., Vergara, P., Deneke, T., Kuck, K.-H., Kottkamp, H., Fei, S., et al.: Noninducibility in postinfarction ventricular tachycardia as an end point for ventricular tachycardia ablation and its effects on outcomes. Circ. Arrhythmia Electrophysiol. 7(4), 677–683 (2014)
Aliot, E.M., Stevenson, W.G., Almendral-Garrote, J.M., Bogun, F., Calkins, C.H., Delacretaz, E., Bella, P.D., Hindricks, G., Jaïs, P., Josephson, M.E., et al.: EHRA/HRS expert consensus on catheter ablation of ventricular arrhythmias. Europace 11(6), 771–817 (2009)
Ashikaga, H., Arevalo, H., Vadakkumpadan, F., Blake, R.C., Bayer, J.D., Nazarian, S., Zviman, M.M., Tandri, H., Berger, R.D., Calkins, H., et al.: Feasibility of image-based simulation to estimate ablation target in human ventricular arrhythmia. Heart Rhythm 10(8), 1109–1116 (2013)
Arevalo, H., Plank, G., Helm, P., Halperin, H., Trayanova, N.: Tachycardia in post-infarction hearts insights from 3D image-based ventricular models. PloS one 8(7) (2013). e68872
Cabrera-Lozoya, R., et al.: Confidence-based training for clinical data uncertainty in image-based prediction of cardiac ablation targets. In: Menze, B., et al. (eds.) MCV 2014. LNCS, vol. 8848, pp. 148–159. Springer, Cham (2014). doi:10.1007/978-3-319-13972-2_14
Chen, Z., Cabrera-Lozoya, R., Relan, J., Sohal, M., Shetty, A., Karim, R., Delingette, H., Gill, J., Rhode, K., Ayache, N., et al.: Biophysical modeling predicts ventricular tachycardia inducibility and circuit morphology: a combined clinical validation and computer modeling approach. J. Cardiovasc. Electrophysiol. 27(7), 851–860 (2016)
Wang, L., Gharbia, O.A., Horáček, B.M., Sapp, J.L.: Noninvasive epicardial and endocardial electrocardiographic imaging of scar-related ventricular tachycardia. J. Electrocardiol. 49(6), 887–893 (2016)
Komatsu, Y., Cochet, H., Jadidi, A., Sacher, F., Shah, A., Derval, N., Scherr, D., Pascale, P., Roten, L., Denis, A., et al.: Regional myocardial wall thinning at multi-detector computed tomography correlates to arrhythmogenic substrate in post-infarction ventricular tachycardia: assessment of structural and electrical substrate. Circ. Arrhythmia Electrophysiol. 6(2), 342–350 (2013)
Yezzi, A.J., Prince, J.L.: An eulerian PDE approach for computing tissue thickness. IEEE Trans. Med. Imaging 22(10), 1332–1339 (2003)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this paper
Cite this paper
Cedilnik, N., Duchateau, J., Dubois, R., Jaïs, P., Cochet, H., Sermesant, M. (2017). VT Scan: Towards an Efficient Pipeline from Computed Tomography Images to Ventricular Tachycardia Ablation. In: Pop, M., Wright, G. (eds) Functional Imaging and Modelling of the Heart. FIMH 2017. Lecture Notes in Computer Science(), vol 10263. Springer, Cham. https://doi.org/10.1007/978-3-319-59448-4_26
Download citation
DOI: https://doi.org/10.1007/978-3-319-59448-4_26
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59447-7
Online ISBN: 978-3-319-59448-4
eBook Packages: Computer ScienceComputer Science (R0)