Digital twin of atria for atrial fibrillation patients
An ablation procedure guidance method is provided herein. The ablation procedure guidance method is implemented by a generation engine executing on a processor. The ablation procedure guidance method includes receiving inputs including images and conduction velocity vector estimations and generating a digital twin of an anatomical structure utilizing the images and the conduction velocity vector estimations. The ablation procedure guidance method also includes presenting, via a user interface of the generation engine, the digital twin to provide precision ablation guidance of the anatomical structure and provide electrophysiology information of the anatomical structure.
1 . An ablation procedure guidance method, for improving intra-procedural mapping accuracy and ablation efficacy by generating and validating a patient-specific electrophysiology digital twin and using it to parameterize energy delivery, implemented by one or more processors, the method comprising:
receiving, by the one or more processors, inputs comprising (i) intracardiac electrogram signals acquired from a multi-electrode intracardiac catheter at known electrode positions and (ii) one or more images registered to a three-dimensional atrial geometry;
estimating, by the one or more processors, direction-of-arrival values from the intracardiac electrogram signals at surface sample points of the atrial geometry by computing time-of-arrival differences across electrode neighborhoods within a time window of interest;
computing, by the one or more processors, conduction velocity vector estimations as a vector field over the atrial geometry by fitting the vector field to direction-of-arrival values derived from the intracardiac electrogram signals and regularizing the fitted vector field to satisfy smoothness and physiological-conduction constraints across the atrial surface;
generating, by the one or more processors, a digital twin of an anatomical structure using the one or more images and the conduction velocity vector estimations;
performing, by the one or more processors, a forward activation-propagation simulation on the digital twin to generate local activation time values;
validating, by the one or more processors, the digital twin by comparing the local activation time values to corresponding measured values and accepting the digital twin when a estimation error satisfies a tolerance;
generating, by the one or more processors, an ablation procedure guidance plan comprising: lesion locations on the atrial surface, a delivery sequence, and energy-delivery parameters;
transmitting, by the one or more processors, control signals encoding the energy-delivery parameters to an ablation generator for execution of an ablation procedure according to the delivery sequence; and
presenting, via a user interface of the generation engine, the digital twin with overlaid conduction-velocity vectors and local activation time maps to provide precision ablation guidance and electrophysiology information of the anatomical structure.
2 . The ablation procedure guidance method of claim 1 , wherein the inputs further comprise baseline recordings of intracardiac electrogram signals or a lattice Boltzmann model.
3 . The ablation procedure guidance method of claim 1 , estimating the direction-of-arrival values further comprises rejecting outlier time-of-arrival differences that fail a quality threshold within the time window of interest.
4 . The ablation procedure guidance method of claim 1 , wherein the one or more inputs further comprise arrhythmogenic activity from the intracardiac electrocardiogram or a body surface electrocardiogram.
5 . The ablation procedure guidance method of claim 1 , computing the conduction velocity vector field further comprises applying model constraints that incorporate conduction criteria and non-conductive boundary conditions corresponding to scar ablated tissue.
6 . The ablation procedure guidance method of claim 1 , wherein the precision ablation guidance includes simulating how electricity flows through the digital twin based on the conduction velocity vector estimations and determining whether a targeted propagation pathway is interrupted.
7 . The ablation procedure guidance method of claim 1 , further comprising receiving one or more additional inputs during the ablation procedure and, in response, generating different ablation procedure guidance or performing a remapping operation of the digital twin.
8 . The ablation procedure guidance method of claim 1 , further comprising generating a digital-twin local activation time map based on a digital-twin model, and updating conduction velocity vector estimations of lesioned surface elements in the digital-twin model according to an ablation model and re-simulating activation propagation to confirm termination of a targeted pathway.
9 . The ablation procedure guidance method of claim 1 , wherein the precision ablation guidance includes simulating interactions between focal activities with respect to the digital twin and determining one or more foci for ablation based on the one or more interactions.
10 . The ablation procedure guidance method of claim 1 , wherein the anatomical structure comprises atria of a heart, and wherein the inputs comprise patient-specific data acquired intra-procedurally.
11 . A system for improving intra-procedural mapping accuracy and ablation efficacy by generating and validating a patient-specific electrophysiology digital twin and using it to parameterize energy delivery, comprising:
a multi-electrode intracardiac catheter;
an imaging subsystem configured to provide a three-dimensional atrial geometry registered to electrode positions;
an ablation generator configured to deliver therapeutic energy;
one or more processors; and
non-transitory computer readable memory storing instructions that, when executed by the one or more processors, cause the system to:
receive inputs comprising images and intracardiac electrogram signals from the catheter and the three-dimensional atrial geometry from the imaging subsystem;
estimate direction-of-arrival values at surface sample points by computing time-of-arrival differences across electrode neighborhoods within a time window of interest;
compute conduction velocity vector estimations as a vector field over the atrial geometry by fitting the vector field to direction-of-arrival values derived from the intracardiac electrogram signals and regularizing the fitted vector field to satisfy smoothness and physiological-conduction constraints across the atrial surface;
generate a digital twin of an anatomical structure using the one or more images and the conduction velocity vector estimations;
perform forward activation-propagation simulation on the digital twin to generate local activation time values;
validate the digital twin against measured local activation time values by accepting the digital twin when a estimation error satisfies a tolerance;
generate an ablation procedure guidance plan comprising: lesion locations, a delivery sequence, and energy-delivery parameters;
transmit control signals encoding the energy-delivery parameters to the ablation generator for execution of an ablation procedure according to the delivery sequence;
and present, via a user interface, the digital twin with overlaid conduction-velocity vectors and local activation time maps to provide precision ablation guidance and electrophysiology information.
12 . The system of claim 11 , wherein the one or more inputs comprise the one or more images, the conduction velocity vector estimations, and further comprise baseline recordings of intracardiac electrogram signals or a lattice Boltzmann model.
13 . The system of claim 11 , wherein estimating direction-of-arrival values further comprises rejecting outlier time-of-arrival differences that fail a quality threshold within the time window of interest.
14 . The system of claim 11 , validating the digital twin comprises accepting the digital twin when estimation error between simulated and measured local activation time values satisfies a tolerance.
15 . The system of claim 11 , wherein the ablation generator is a radiofrequency generator and the control signals specify at least one of power, or time.
16 . The system of claim 11 , wherein the ablation generator is a pulsed-field ablation generator and the control signals specify at least one of pulse amplitude, or pulse width.
17 . The system of claim 11 , wherein the instructions further cause the system to update direction-of-arrival estimation, conduction-velocity computation, forward simulation, validation, and the ablation plan intra-procedurally in response to newly acquired intracardiac electrogram signals.
18 . The system of claim 11 , wherein computing the conduction-velocity vector field further comprises applying model constraints that incorporate conduction criteria and non-conductive boundary conditions corresponding to scar or ablated tissue.
19 . The system of claim 11 , wherein the instructions further cause the system to update conduction-velocity vector estimations of lesioned surface elements in the digital-twin model according to an ablation model and to re-simulate activation propagation to confirm interruption of a targeted pathway.