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SHR Neuro Cancer Cardio Lipid Metab Microb

Campos, FO; Neic, A; Mendonca, Costa, C; Whitaker, J; O'Neill, M; Razavi, R; Rinaldi, CA; DanielScherr; Niederer, SA; Plank, G; Bishop, MJ.
An automated near-real time computational method for induction and treatment of scar-related ventricular tachycardias.
Med Image Anal. 2022; 80:102483 Doi: 10.1016/j.media.2022.102483
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Leading authors Med Uni Graz
Campos Fernando Otaviano
Co-authors Med Uni Graz
Mendonca Costa Caroline
Neic Aurel-Vasile
Plank Gernot
Scherr Daniel
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Abstract:
Catheter ablation is currently the only curative treatment for scar-related ventricular tachycardias (VTs). However, not only are ablation procedures long, with relatively high risk, but success rates are punitively low, with frequent VT recurrence. Personalized in-silico approaches have the opportunity to address these limitations. However, state-of-the-art reaction diffusion (R-D) simulations of VT induction and subsequent circuits used for in-silico ablation target identification require long execution times, along with vast computational resources, which are incompatible with the clinical workflow. Here, we present the Virtual Induction and Treatment of Arrhythmias (VITA), a novel, rapid and fully automated computational approach that uses reaction-Eikonal methodology to induce VT and identify subsequent ablation targets. The rationale for VITA is based on finding isosurfaces associated with an activation wavefront that splits in the ventricles due to the presence of an isolated isthmus of conduction within the scar; once identified, each isthmus may be assessed for their vulnerability to sustain a reentrant circuit, and the corresponding exit site automatically identified for potential ablation targeting. VITA was tested on a virtual cohort of 7 post-infarcted porcine hearts and the results compared to R-D simulations. Using only a standard desktop machine, VITA could detect all scar-related VTs, simulating activation time maps and ECGs (for clinical comparison) as well as computing ablation targets in 48 minutes. The comparable VTs probed by the R-D simulations took 68.5 hours on 256 cores of high-performance computing infrastructure. The set of lesions computed by VITA was shown to render the ventricular model VT-free. VITA could be used in near real-time as a complementary modality aiding in clinical decision-making in the treatment of post-infarction VTs.
Find related publications in this database (using NLM MeSH Indexing)
Animals - administration & dosage
Arrhythmias, Cardiac - surgery
Catheter Ablation - administration & dosage
Cicatrix - administration & dosage
Electrocardiography - administration & dosage
Humans - administration & dosage
Myocardial Infarction - administration & dosage
Swine - administration & dosage
Tachycardia, Ventricular - diagnostic imaging, surgery

Find related publications in this database (Keywords)
Myocardial infarction
Ventricular tachycardia
Catheter ablation
Computational modeling
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