Novel method for comparison of pre-planned ablation lines for treatment of atrial fibrillation using a common reference model

Abstract

The standard approach in interventional treatment of atrial fibrillation (AFib) is pulmonary vein isolation (PVI). PVI can be achieved by placing radio-frequency (RF) lesions contiguously around the pulmonary veins attached to the left atrium. Since accurate lesion placement may be difficult, pre-planned ablation lines can be used for better navigation both when using mapping systems or also when relying on fluoro overlay techniques. By working with physicians in this field, we learned that clinically acceptable ablation lines are not necessarily limited to a unique line, but there appears to be some flexibility when defining regions within which ablation should be performed. We present a novel method to investigate the dimensions of such a region based on comparing pre-planned ablation lines set up for different left atria. A common reference model is proposed as a means to combine and compare different pre-planned ablation lines. Based on our data, we found an average deviation of individually pre-planned ablation lines from their respective mean of 2.9±1.9 mm and 1.8±1.5 mm for right and left sided ipsilateral planning lines, respectively. Beyond ablation line assessment, this work also introduces a framework which can be extended to automatic pre-planning of ablation lines for PVI procedures.