0000000000319283

AUTHOR

Alessandro Cristoforetti

0000-0003-1665-6656

A Novel Approach to Propagation Pattern Analysis in Intracardiac Atrial Fibrillation Signals

The purpose of this study is to investigate propagation patterns in intracardiac signals recorded during atrial fibrillation (AF) using an approach based on partial directed coherence (PDC), which evaluates directional coupling between multiple signals in the frequency domain. The PDC is evaluated at the dominant frequency of AF signals and tested for significance using a surrogate data procedure specifically designed to assess causality. For significantly coupled sites, the approach allows also to estimate the delay in propagation. The methods potential is illustrated with two simulation scenarios based on a detailed ionic model of the human atrial myocyte as well as with real data recordi…

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A stochastic approach for automatic registration and fusion of left atrial electroanatomic maps with 3D CT anatomical images.

The integration of electroanatomic maps with highly resolved computed tomography cardiac images plays an important role in the successful planning of the ablation procedure of arrhythmias. In this paper, we present and validate a fully-automated strategy for the registration and fusion of sparse, atrial endocardial electroanatomic maps (CARTO maps) with detailed left atrial (LA) anatomical reconstructions segmented from a pre-procedural MDCT scan. Registration is accomplished by a parameterized geometric transformation of the CARTO points and by a stochastic search of the best parameter set which minimizes the misalignment between transformed CARTO points and the LA surface. The subsequent …

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A Multi-Variate Predictability Framework to Assess Invasive Cardiac Activity and Interactions during Atrial Fibrillation

Objective: This study introduces a predictability framework based on the concept of Granger causality (GC), in order to analyze the activity and interactions between different intracardiac sites during atrial fibrillation (AF). Methods: GC-based interactions were studied using a three-electrode analysis scheme with multi-variate autoregressive models of the involved preprocessed intracardiac signals. The method was evaluated in different scenarios covering simulations of complex atrial activity as well as endocardial signals acquired from patients. Results: The results illustrate the ability of the method to determine atrial rhythm complexity and to track and map propagation during AF. Conc…

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Isolation of the left atrial surface from cardiac multi-detector CT images based on marker controlled watershed segmentation

The delineation of left atrium (LA) and pulmonary veins (PVs) anatomy from high resolution images holds importance for atrial fibrillation (AF) investigation and treatment. In this study, a semiautomatic segmentation procedure for LA and PVs inner surface from contrast enhanced CT data was developed. The procedure consists of a three dimensional marker controlled watershed segmentation applied to the external morphological gradient, followed by variable threshold surface extraction from the original intensity image. A preliminary anisotropic non-linear filtering was implemented to improve the S/N ratio of CT images. The performance of segmentation was evaluated on cardiac CT scans of 12 AF …

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Registration and fusion of segmented left atrium CT images with CARTO electrical maps for the ablative treatment of atrial fibrillation

This study aims to extract the interior surface of the left atrium (LA) and pulmonary veins (PVs) from threedimensional tomographic data and to integrate it with LA CARTO electrical maps. The separation of LA and PVs from other overlapping structures of the heart was performed processing 3D CT data by marker-controlled watershed segmentation and surface extraction. CARTO maps were then registered on the L A internal surface by a stochastic optimization algorithm based on simulated annealing. The residual registration error resulted inferior to 3 mm. The integration between electrophysiological and high resolved anatomic information of LA results feasible and may constitute a significant sup…

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