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Electro-Anatomical Characterization of Atrial Microfibrosis in a Histologically Detailed Computer Model

Identifieur interne : 000406 ( Pmc/Corpus ); précédent : 000405; suivant : 000407

Electro-Anatomical Characterization of Atrial Microfibrosis in a Histologically Detailed Computer Model

Auteurs : Fernando O. Campos ; Thomas Wiener ; Anton J. Prassl ; Rodrigo Weber Dos Santos ; Damián Sánchez-Quintana ; Helmut Ahammer ; Gernot Plank ; Ernst Hofer

Source :

RBID : PMC:3786039

Abstract

Fibrosis is thought to play an important role in formation and maintenance of atrial fibrillation (AF). The propensity of fibrosis to increase AF vulnerability depends not only on its amount, its texture plays a crucial role as well. While the detection of fibrotic tissue patches in the atria with extracellular recordings is feasible based on the analysis of electrogram fractionation, as used in clinical practice to identify ablation targets, the classification of fibrotic texture is a more challenging problem. This study seeks to establish a method for the electro-anatomical characterization of the fibrotic textures based on the analysis of electrogram fractionation. The proposed method exploits the dependency of fractionation patterns on the incidence direction of wavefronts which differs significantly as a function of texture. A histologically detailed computer model of the right atrial isthmus was developed for testing the method. A stimulation protocol was conceived which generated various incidence directions for any given recording site where electrograms were computed. A classification method is derived then for discriminating three types of fibrosis, no fibrosis (control), diffuse and patchy fibrosis. Simulation results showed that electrogram fractionation and amplitudes and their dependency upon incidence direction allow a robust discrimination between different classes of fibrosis. Finally, to minimize the technical effort, sensitivity analysis was performed to identify a minimum number of incidence directions required for robust classification.


Url:
DOI: 10.1109/TBME.2013.2256359
PubMed: 23559023
PubMed Central: 3786039

Links to Exploration step

PMC:3786039

Le document en format XML

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<p id="P1">Fibrosis is thought to play an important role in formation and maintenance of atrial fibrillation (AF). The propensity of fibrosis to increase AF vulnerability depends not only on its amount, its texture plays a crucial role as well. While the detection of fibrotic tissue patches in the atria with extracellular recordings is feasible based on the analysis of electrogram fractionation, as used in clinical practice to identify ablation targets, the classification of fibrotic texture is a more challenging problem. This study seeks to establish a method for the electro-anatomical characterization of the fibrotic textures based on the analysis of electrogram fractionation. The proposed method exploits the dependency of fractionation patterns on the incidence direction of wavefronts which differs significantly as a function of texture. A histologically detailed computer model of the right atrial isthmus was developed for testing the method. A stimulation protocol was conceived which generated various incidence directions for any given recording site where electrograms were computed. A classification method is derived then for discriminating three types of fibrosis, no fibrosis (control), diffuse and patchy fibrosis. Simulation results showed that electrogram fractionation and amplitudes and their dependency upon incidence direction allow a robust discrimination between different classes of fibrosis. Finally, to minimize the technical effort, sensitivity analysis was performed to identify a minimum number of incidence directions required for robust classification.</p>
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<name>
<surname>Campos</surname>
<given-names>Fernando O.</given-names>
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<aff id="A1">Institute of Biophysics, Medical University of Graz, and with the Institute of Medical Engineering, Graz University of Technology, Graz, Austria</aff>
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<name>
<surname>Wiener</surname>
<given-names>Thomas</given-names>
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<aff id="A2">Institute of Biophysics, Medical University of Graz, Graz, Austria</aff>
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<contrib contrib-type="author">
<name>
<surname>Weber dos Santos</surname>
<given-names>Rodrigo</given-names>
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<aff id="A4">Department of Computer Science and the Graduate Program in Computational Modeling, Federal University of Juiz de Fora, Juiz de Fora, Brazil</aff>
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<contrib contrib-type="author">
<name>
<surname>Sánchez-Quintana</surname>
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<aff id="A5">Department of Anatomy, Cell Biology and Zoology, University of Extremadura, Badajoz, Spain</aff>
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<contrib contrib-type="author">
<name>
<surname>Ahammer</surname>
<given-names>Helmut</given-names>
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<aff id="A6">Institute of Biophysics, Medical University of Graz, Graz, Austria</aff>
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<aff id="A7">Institute of Biophysics, Medical University of Graz, Graz, Austria, and with the Oxford e-Research Centre, University of Oxford, Oxford, UK (phone: +43-316-380-7756;
<email>gernot.plank@medunigraz.at</email>
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<contrib contrib-type="author">
<name>
<surname>Hofer</surname>
<given-names>Ernst</given-names>
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<aff id="A8">Institute of Biophysics, Medical University of Graz, Graz, Austria</aff>
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<pub-date pub-type="nihms-submitted">
<day>20</day>
<month>5</month>
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<day>03</day>
<month>4</month>
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<month>8</month>
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<day>28</day>
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<volume>60</volume>
<issue>8</issue>
<fpage>2339</fpage>
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<permissions>
<copyright-statement>Copyright © 2013 IEEE.</copyright-statement>
<copyright-year>2013</copyright-year>
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<abstract>
<p id="P1">Fibrosis is thought to play an important role in formation and maintenance of atrial fibrillation (AF). The propensity of fibrosis to increase AF vulnerability depends not only on its amount, its texture plays a crucial role as well. While the detection of fibrotic tissue patches in the atria with extracellular recordings is feasible based on the analysis of electrogram fractionation, as used in clinical practice to identify ablation targets, the classification of fibrotic texture is a more challenging problem. This study seeks to establish a method for the electro-anatomical characterization of the fibrotic textures based on the analysis of electrogram fractionation. The proposed method exploits the dependency of fractionation patterns on the incidence direction of wavefronts which differs significantly as a function of texture. A histologically detailed computer model of the right atrial isthmus was developed for testing the method. A stimulation protocol was conceived which generated various incidence directions for any given recording site where electrograms were computed. A classification method is derived then for discriminating three types of fibrosis, no fibrosis (control), diffuse and patchy fibrosis. Simulation results showed that electrogram fractionation and amplitudes and their dependency upon incidence direction allow a robust discrimination between different classes of fibrosis. Finally, to minimize the technical effort, sensitivity analysis was performed to identify a minimum number of incidence directions required for robust classification.</p>
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<kwd-group>
<title>Index Terms</title>
<kwd>Complex fractionated atrial electrograms</kwd>
<kwd>monodomain model</kwd>
<kwd>fibrosis classification</kwd>
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<funding-source country="United States">National Heart, Lung, and Blood Institute : NHLBI</funding-source>
<award-id>R01 HL101196 || HL</award-id>
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