Standardized unfold mapping: a technique to permit left atrial regional data display and analysis

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• dc.contributor.author Williams, Steven E.
• dc.contributor.author Tobón Gómez, Catalina, 1981-
• dc.contributor.author Zuluaga, Maria A.
• dc.contributor.author Chubb, Henry
• dc.contributor.author Butakoff, Constantine
• dc.contributor.author Karim, Rashed
• dc.contributor.author Ahmed, Elena
• dc.contributor.author Camara, Oscar
• dc.contributor.author Rhode, Kawal
• dc.date.accessioned 2021-07-09T09:19:38Z
• dc.date.available 2021-07-09T09:19:38Z
• dc.date.issued 2017
• dc.description.abstract Purpose: Left atrial arrhythmia substrate assessment can involve multiple imaging and electrical modalities, but visual analysis of data on 3D surfaces is time-consuming and suffers from limited reproducibility. Unfold maps (e.g., the left ventricular bull’s eye plot) allow 2D visualization, facilitate multimodal data representation, and provide a common reference space for inter-subject comparison. The aim of this work is to develop a method for automatic representation of multimodal information on a left atrial standardized unfold map (LA-SUM). Methods: The LA-SUM technique was developed and validated using 18 electroanatomic mapping (EAM) LA geometries before being applied to ten cardiac magnetic resonance/EAM paired geometries. The LA-SUM was defined as an unfold template of an average LA mesh, and registration of clinical data to this mesh facilitated creation of new LA-SUMs by surface parameterization. Results: The LA-SUM represents 24 LA regions on a flattened surface. Intra-observer variability of LA-SUMs for both EAM and CMR datasets was minimal; root-mean square difference of 0.008 ± 0.010 and 0.007 ± 0.005 ms (local activation time maps), 0.068 ± 0.063 gs (force-time integral maps), and 0.031 ± 0.026 (CMR LGE signal intensity maps). Following validation, LA-SUMs were used for automatic quantification of post-ablation scar formation using CMR imaging, demonstrating a weak but significant relationship between ablation force-time integral and scar coverage (R 2 = 0.18, P < 0.0001). Conclusions: The proposed LA-SUM displays an integrated unfold map for multimodal information. The method is applicable to any LA surface, including those derived from imaging and EAM systems. The LA-SUM would facilitate standardization of future research studies involving segmental analysis of the LA.
• dc.description.sponsorship This work was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London. The views expressed here are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health. M.A. Zuluaga is funded by the EPSRC (EP/H046410/1). C. Butakoff and O. Camara are funded by the Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 611823 and by the Spanish Ministry of Economy and Competitiveness (TIN2011-28067).
• dc.format.mimetype application/pdf
• dc.identifier.citation Williams SE, Tobon-Gomez C, Zuluaga MA, Chubb H, Butakoff C, Karim R, Ahmed E, Camara O, Rhode KS. Standardized unfold mapping: a technique to permit left atrial regional data display and analysis. Card Electrophysiol Rev. 2017;50:125-31. DOI: 10.1007/s10840-017-0281-3
• dc.identifier.doi http://dx.doi.org/10.1007/s10840-017-0281-3
• dc.identifier.issn 1385-2264
• dc.identifier.uri http://hdl.handle.net/10230/48141
• dc.language.iso eng
• dc.publisher Springer
• dc.relation.ispartof Cardiac Electrophysiology Review. 2017;50:125-31
• dc.relation.projectID info:eu-repo/grantAgreement/EC/FP7/611823
• dc.relation.projectID info:eu-repo/grantAgreement/ES/3PN/TIN2011-28067
• dc.rights © The Author(s) 2017. This article is an open access publication. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/
• dc.subject.keyword Atrial fibrillation
• dc.subject.keyword Catheter ablation
• dc.subject.keyword Cardiac magnetic resonance
• dc.subject.keyword Unfold map
• dc.subject.keyword Regional analysis
• dc.subject.keyword Contact-force analysis
• dc.title Standardized unfold mapping: a technique to permit left atrial regional data display and analysis
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion