Williams, Steven E.Tobón Gómez, Catalina, 1981-Zuluaga, Maria A.Chubb, HenryButakoff, ConstantineKarim, RashedAhmed, ElenaCamara, OscarRhode, Kawal2021-07-092021-07-092017Williams 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/s10840-017-0281-31385-2264http://hdl.handle.net/10230/48141Purpose: 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.application/pdfeng© 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.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1007/s10840-017-0281-3Atrial fibrillationCatheter ablationCardiac magnetic resonanceUnfold mapRegional analysisContact-force analysisinfo:eu-repo/semantics/openAccess