Abstract:

Efficient personalized ablation strategies for treating atrial arrhythmias remain challenging. Discrepancies in identifying arrhythmogenic areas using characterization methods, such as late gadolinium enhanced magnetic resonance imaging (LGE-MRI) and electroanatomical mapping, require a comparative analysis of local impedance (LI) and LGE-MRI data. This study aims to analyze correlations as basis for im- provement of treatment strategies. 16 patients undergoing left atrium (LA) ablation with LGE-MRI acquisition and LI data recording were recruited. LGE-MRI data and LI measurements were normalized to patient- and modality-specific blood pool references. A global mean shape was generated based on all patient geometries, and normalized local impedance (LIN) and LGE-MRI image intensity ratio (IIR) data points were co- registered for comparison.Data analysis comprised intra-patient and inter-patient assess- ments, evaluating differences in LIN values among datasets categorized by their IIR. Due to substantial deviations in LIN values, even within the same patient and IIR-category, discern- ing the presence or absence of a correlation was challenging, and no statistically significant correlation could be identified. Our findings underscore the necessity for standardized proto- cols in data acquisition, processing, and comparison, to mini- mize unquantified confounding effects. While immediate substitution of LI for LGE-MRI seems improbable given the significant LIN variations, this preliminary study lays the ground- work for systematic data acquisition. By ensuring data quality, a meaningful comparison between LI and LGE-MRI data can be facilitated, potentially shaping future strategies for atrial ar- rhythmia treatment.