Atrial shape
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LA shape Credit to Marta Presenting Pablo London, 11 th June 2015
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Transcript of Atrial shape
LA shape
Credit to MartaPresenting Pablo
London, 11th June 2015
Why LA shape?• Predictor of AF ablation
recurrence:– AP diameter in echo [Hoit et
al, 2014]– Sphericity in bright-blood MRI
[Bisbal et al, 2013]
• Hypotheses– LA remodelling is a signature
of disease, new shape patterns to be revealed.• At different times of the cycle
– LA curvature drives rotor behaviour in human LA
[Dierckx et al, 2013]
[Bisbal et al, 2013]
LA shape model (I)
• Data: Bisbal cohort:– 144 patients– Recurrence data along time (30m)– Pre-ablation bright-blood MRIs
• Methods: – Segmented using CARTO– automatic meshing, adapted from
[Lamata14]
LA shape model (II)
• Learn anatomical modes (principal component analysis)
• Learn “remodeling signature” that predicts recurrence (linear discriminant analysis)
Recurrent and Non-Recurrent LAs• Shape model to synthesize extremes:– Can be used in AF modelling…
Predict recurrence *• Metric: AUC of the ROC– Resubstitution or cross-validation
* Varela et al, submitted to AHA Conf 2015
Mechanistic explanation: LA curvature influences rotor behaviour
• Recurrent and non-recurrent shapes have different curvature gradients.– Curvature influences rotor behaviour [Dierckx et al, 2013].
• Is this a relevant effect in patient LA shapes?
Yes!
Next steps
• More data to explore– Dynamic sequences with enough resolution
• Clinical questions where shape can be a marker of disease progression
• Simulations to compare healthy / disease realistic anatomies.
