System and method for patient specific planning and guidance of electrophysiology interventions

1. A method for patient-specific planning and guidance of electrophysiological interventions, comprising:

generating a patient-specific anatomical heart model from cardiac image data of a patient;

generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements;

performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model; and

calculating an electrocardiogram (ECG) signal in response to the virtual electrophysiological intervention by:

calculating extra-cellular potentials based on transmembrane potentials calculated using the patient-specific cardiac electrophysiology model at a plurality of points within the myocardium,

calculating body surface potentials at a plurality of points on the torso based on the extra-cellular potentials, and

calculating the ECG signal using the body surface potentials at points on the torso corresponding to ECG lead locations.

2. The method of claim 1 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient comprises:

extracting a multi-component patient-specific heart morphology model from the cardiac image data;

fusing the multi-component patient-specific heart morphology model into a single heart model and tagging elements of the single heart model according to the multiple components; and

generating a model of myocardium fiber architecture based on the single heart model.

3. The method of claim 2 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

segmenting at least one of scar or healing tissue in the cardiac image data; and

mapping the segmented at least one of scar or healing tissue to the single heart model.

4. The method of claim 2 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

extracting a coronary sinus centerline from the cardiac image data; and

mapping the coronary sinus to the single heart model based on the extracted coronary sinus centerline.

5. The method of claim 1 , further comprising:

registering the patient-specific electrophysiology measurements to the patient-specific anatomical heart model prior to generating the patient-specific cardiac electrophysiology model.

6. The method of claim 5 , wherein the patient-specific electrophysiology measurements are pre-operative patient-specific electrophysiology measurements.

7. The method of claim 6 , wherein the pre-operative patient-specific electrophysiology measurements include diagnostic endocardial mappings and registering the patient-specific electrophysiology measurements to the patient-specific anatomical heart model prior to generating the patient-specific cardiac electrophysiology model comprises:

registering the diagnostic endocardial mappings to the patient-specific anatomical heart model using spatial fiducials provided in the diagnostic endocardial mappings.

8. The method of claim 5 , wherein the patient-specific electrophysiology measurements are intra-operative electrophysiology measurements acquired during an electrophysiology intervention.

9. The method of claim 8 , wherein the intra-operative electrophysiology measurements include intra-operative endocardial mappings and registering the patient-specific electrophysiology measurements to the patient-specific anatomical heart model prior to generating the patient-specific cardiac electrophysiology model comprises one of:

registering the intra-operative endocardial mappings to the patient-specific anatomical heart model using spatial fiducials provided in the intra-operative endocardial mappings; and

registering the patient-specific anatomical heart model to medical image data acquired during the electrophysiological intervention.

10. The method of claim 1 , wherein the patient-specific electrophysiology measurements include at least one of endocardial mappings, ECG measurements, or body surface mappings (BSM).

11. The method of claim 1 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements comprises:

generating a Cartesian grid domain using the patient-specific anatomical heart model; and

calculating transmembrane potential variation over time at each of a plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model for each of the plurality of nodes using a Lattice-Boltzmann method for electrophysiology.

12. The method of claim 11 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements further comprises:

estimating parameters of the cardiac electrophysiology model using an inverse problem approach.

13. The method of claim 12 , wherein estimating parameters of the cardiac electrophysiology model using an inverse problem approach comprises:

calculating a cost function that compares cardiac electrophysiology calculated at the plurality of nodes using the cardiac electrophysiology model with the patient-specific electrophysiology measurements;

estimating parameters of the cardiac electrophysiology model using an inverse problem algorithm to minimize the cost function; and

re-calculating the transmembrane potential variation over time at each of the plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model with the estimated parameters for each of the plurality of nodes using the Lattice-Boltzmann method for electrophysiology.

14. The method of claim 1 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual pacing catheter.

15. The method of claim 14 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model further comprises:

receiving a user input selecting the spatial location and pacing protocols of the virtual pacing catheter.

16. The method of claim 14 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model further comprises:

automatically selecting a plurality of spatial locations and pacing protocols at which to perform virtual pacing.

17. The method of claim 16 , wherein calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual pacing catheter comprises:

for each of the plurality of spatial locations, calculating the transmembrane potential variation over time at the plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at that spatial location and applied at one or more different frequencies.

18. The method of claim 1 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual ablation catheter.

19. The method of claim 1 , further comprising:

displaying a visualization of the ECG signal.

20. The method of claim 1 , further comprising:

calculating one or more virtual ECG parameters based on the calculated ECG signal.

21. An apparatus for patient-specific planning and guidance of electrophysiological interventions, comprising:

a processor; and

a memory storing computer program instructions, which when executed by the processor cause the processor to perform operations comprising:

generating a patient-specific anatomical heart model from cardiac image data of a patient;

generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements;

performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model; and

calculating an electrocardiogram (ECG) signal in response to the virtual electrophysiological intervention by:

calculating extra-cellular potentials based on transmembrane potentials calculated using the patient-specific cardiac electrophysiology model at a plurality of points within the myocardium,

calculating body surface potentials at a plurality of points on the torso based on the extra-cellular potentials, and

calculating the ECG signal using the body surface potentials at points on the torso corresponding to ECG lead locations.

22. The apparatus of claim 21 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient comprises:

extracting a multi-component patient-specific heart morphology model from the cardiac image data;

fusing the multi-component patient-specific heart morphology model into a single heart model and tagging elements of the single heart model according to the multiple components; and

generating a model of myocardium fiber architecture based on the single heart model.

23. The apparatus of claim 22 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

segmenting at least one of scar or healing tissue in the cardiac image data; and

mapping the segmented at least one of scar or healing tissue to the single heart model.

24. The apparatus of claim 22 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

extracting a coronary sinus centerline from the cardiac image data; and

mapping the coronary sinus to the single heart model based on the extracted coronary sinus centerline.

25. The apparatus of claim 21 , wherein the operations further comprise:

registering the patient-specific electrophysiology measurements to the patient-specific anatomical heart model prior to generating the patient-specific cardiac electrophysiology model.

26. The apparatus of claim 25 , wherein the patient-specific electrophysiology measurements are pre-operative patient-specific electrophysiology measurements.

27. The apparatus of claim 25 , wherein the patient-specific electrophysiology measurements are intra-operative electrophysiology measurements acquired during an electrophysiology intervention.

28. The apparatus of claim 21 , wherein the patient-specific electrophysiology measurements include at least one of endocardial mappings, ECG measurements, or body surface mappings (BSM).

29. The apparatus of claim 21 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements comprises:

generating a Cartesian grid domain using the patient-specific anatomical heart model; and

calculating transmembrane potential variation over time at each of a plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model for each of the plurality of nodes using a Lattice-Boltzmann method for electrophysiology.

30. The apparatus of claim 29 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements further comprises:

estimating parameters of the cardiac electrophysiology model using an inverse problem approach.

31. The apparatus of claim 30 , wherein estimating parameters of the cardiac electrophysiology model using an inverse problem approach comprises:

calculating a cost function that compares cardiac electrophysiology calculated at the plurality of nodes using the cardiac electrophysiology model with the patient-specific electrophysiology measurements;

estimating parameters of the cardiac electrophysiology model using an inverse problem algorithm to minimize the cost function; and

re-calculating the transmembrane potential variation over time at each of the plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model with the estimated parameters for each of the plurality of nodes using the Lattice-Boltzmann method for electrophysiology.

32. The apparatus of claim 21 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual pacing catheter.

33. The apparatus of claim 21 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual ablation catheter.

34. The apparatus of claim 21 , wherein the operations further comprise:

displaying a visualization of the ECG signal.

35. The apparatus of claim 21 , wherein the operations further comprise:

calculating one or more virtual ECG parameters based on the calculated ECG signal.

36. A non-transitory computer readable medium storing computer program instructions for patient-specific planning and guidance of electrophysiological interventions, the computer program instructions when executed by a processor cause the processor to perform operations comprising:

generating a patient-specific anatomical heart model from cardiac image data of a patient;

generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements;

performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model; and

calculating an electrocardiogram (ECG) signal in response to the virtual electrophysiological intervention by:

calculating extra-cellular potentials based on transmembrane potentials calculated using the patient-specific cardiac electrophysiology model at a plurality of points within the myocardium,

calculating body surface potentials at a plurality of points on the torso based on the extra-cellular potentials, and

calculating the ECG signal using the body surface potentials at points on the torso corresponding to ECG lead locations.

37. The non-transitory computer readable medium of claim 36 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient comprises:

extracting a multi-component patient-specific heart morphology model from the cardiac image data;

fusing the multi-component patient-specific heart morphology model into a single heart model and tagging elements of the single heart model according to the multiple components; and

generating a model of myocardium fiber architecture based on the single heart model.

38. The non-transitory computer readable medium of claim 37 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

segmenting at least one of scar or healing tissue in the cardiac image data; and

mapping the segmented at least one of scar or healing tissue to the single heart model.

39. The non-transitory computer readable medium of claim 37 , wherein generating a patient-specific anatomical heart model from cardiac image data of a patient further comprises:

extracting a coronary sinus centerline from the cardiac image data; and

mapping the coronary sinus to the single heart model based on the extracted coronary sinus centerline.

40. The non-transitory computer readable medium of claim 36 , wherein the operations further comprise:

registering the patient-specific electrophysiology measurements to the patient-specific anatomical heart model prior to generating the patient-specific cardiac electrophysiology model.

41. The non-transitory computer readable medium of claim 40 , wherein the patient-specific electrophysiology measurements are pre-operative patient-specific electrophysiology measurements.

42. The non-transitory computer readable medium of claim 40 , wherein the patient-specific electrophysiology measurements are intra-operative electrophysiology measurements acquired during an electrophysiology intervention.

43. The non-transitory computer readable medium of claim 36 , wherein the patient-specific electrophysiology measurements include at least one of endocardial mappings, ECG measurements, or body surface mappings (BSM).

44. The non-transitory computer readable medium of claim 36 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements comprises:

generating a Cartesian grid domain using the patient-specific anatomical heart model; and

calculating transmembrane potential variation over time at each of a plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model for each of the plurality of nodes using a Lattice-Boltzmann method for electrophysiology.

45. The non-transitory computer readable medium of claim 44 , wherein generating a patient-specific cardiac electrophysiology model based on the patient-specific anatomical heart model and patient-specific electrophysiology measurements further comprises:

estimating parameters of the cardiac electrophysiology model using an inverse problem approach.

46. The non-transitory computer readable medium of claim 45 , wherein estimating parameters of the cardiac electrophysiology model using an inverse problem approach comprises:

calculating a cost function that compares cardiac electrophysiology calculated at the plurality of nodes using the cardiac electrophysiology model with the patient-specific electrophysiology measurements;

estimating parameters of the cardiac electrophysiology model using an inverse problem algorithm to minimize the cost function; and

re-calculating the transmembrane potential variation over time at each of the plurality of nodes within the myocardium in the Cartesian grid domain by computing a solution of a cardiac electrophysiology model with the estimated parameters for each of the plurality of nodes using the Lattice-Boltzmann method for electrophysiology.

47. The non-transitory computer readable medium of claim 36 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual pacing catheter.

48. The non-transitory computer readable medium of claim 36 , wherein performing a virtual electrophysiological intervention using the patient-specific cardiac electrophysiology model comprises:

calculating transmembrane potential variation over time at a plurality of points within the myocardium using the patient-specific cardiac electrophysiology model with a stimulus current added at a spatial location of a virtual ablation catheter.

49. The non-transitory computer readable medium of claim 36 , wherein the operations further comprise:

displaying a visualization of the ECG signal.

50. The non-transitory computer readable medium of claim 36 , wherein the operations further comprise:

calculating one or more virtual ECG parameters based on the simulated ECG signal.