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Yue JY, Li PC, Li MX, Wu QW, Liang CH, Chen J, Zhu ZP, Li PH, Dou WG, Gao JB. An Exploratory Pilot Study on the Application of Radiofrequency Ablation for Atrial Fibrillation Guided by Computed Tomography-Based 3D Printing Technology. J Imaging Inform Med 2024:10.1007/s10278-024-01081-2. [PMID: 38491235 DOI: 10.1007/s10278-024-01081-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 03/18/2024]
Abstract
Radiofrequency ablation (RFA) is the treatment of choice for atrial fibrillation (AF). Additionally, the utilization of 3D printing for cardiac models offers an in-depth insight into cardiac anatomy and cardiovascular diseases. The study aims to evaluate the clinical utility and outcomes of RFA following in vitro visualization of the left atrium (LA) and pulmonary vein (PV) structures via 3D printing (3DP). Between November 2017 and April 2021, patients who underwent RFA at the First Affiliated Hospital of Xinxiang Medical University were consecutively enrolled and randomly allocated into two groups: the 3DP group and the control group, in a 1:1 ratio. Computed tomography angiography (CTA) was employed to capture the morphology and diameter of the LA and PV, which facilitated the construction of a 3D entity model. Additionally, surgical procedures were simulated using the 3D model. Parameters such as the duration of the procedure, complications, and rates of RFA recurrence were meticulously documented. Statistical analysis was performed using the t-test or Mann-Whitney U test to evaluate the differences between the groups, with a P-value of less than 0.05 considered statistically significant. In this study, a total of 122 patients were included, with 53 allocated to the 3DP group and 69 to the control group. The analysis of the morphological measurements of the LA and PV taken from the workstation or direct entity measurement showed no significant difference between the two groups (P > 0.05). However, patients in the 3DP group experienced significantly shorter RFA times (97.03 ± 28.39 compared to 120.51 ± 44.76 min, t = 3.05, P = 0.003), reduced duration of radiation exposure (2.55 [interquartile range 2.01, 3.24] versus 3.20 [2.28, 3.91] min, Z = 3.23, P < 0.001), and shorter modeling times (7.68 ± 1.03 compared to 8.89 ± 1.45 min, t = 5.38, P < 0.001). 3DP technology has the potential to enhance standard RFA practices by reducing the time required for intraoperative interventions and exposure to radiation.
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Affiliation(s)
- Jun-Yan Yue
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Erqi District, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
- Heart Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
- Medical Imaging School of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Pei-Cheng Li
- Electrophysiology Laboratory, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Mei-Xia Li
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Qing-Wu Wu
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Chang-Hua Liang
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Jie Chen
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Zhi-Ping Zhu
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Pei-Heng Li
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Wen-Guang Dou
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, Henan, China
| | - Jian-Bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Erqi District, No. 1 Jianshe East Road, Zhengzhou, 450000, Henan, China.
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Mohenska M, Tan NM, Tokolyi A, Furtado MB, Costa MW, Perry AJ, Hatwell-Humble J, van Duijvenboden K, Nim HT, Ji YMM, Charitakis N, Bienroth D, Bolk F, Vivien C, Knaupp AS, Powell DR, Elliott DA, Porrello ER, Nilsson SK, Del Monte-Nieto G, Rosenthal NA, Rossello FJ, Polo JM, Ramialison M. 3D-cardiomics: A spatial transcriptional atlas of the mammalian heart. J Mol Cell Cardiol 2021; 163:20-32. [PMID: 34624332 DOI: 10.1016/j.yjmcc.2021.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/03/2021] [Accepted: 09/28/2021] [Indexed: 12/13/2022]
Abstract
Understanding the spatial gene expression and regulation in the heart is key to uncovering its developmental and physiological processes, during homeostasis and disease. Numerous techniques exist to gain gene expression and regulation information in organs such as the heart, but few utilize intuitive true-to-life three-dimensional representations to analyze and visualise results. Here we combined transcriptomics with 3D-modelling to interrogate spatial gene expression in the mammalian heart. For this, we microdissected and sequenced transcriptome-wide 18 anatomical sections of the adult mouse heart. Our study has unveiled known and novel genes that display complex spatial expression in the heart sub-compartments. We have also created 3D-cardiomics, an interface for spatial transcriptome analysis and visualization that allows the easy exploration of these data in a 3D model of the heart. 3D-cardiomics is accessible from http://3d-cardiomics.erc.monash.edu/.
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Affiliation(s)
- Monika Mohenska
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, Victoria, Australia; Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Wellington Road, Clayton, Victoria, Australia; Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Nathalia M Tan
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, Victoria, Australia; Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Wellington Road, Clayton, Victoria, Australia; Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Alex Tokolyi
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Milena B Furtado
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; The Jackson Laboratory, Bar Harbor, ME, USA
| | - Mauro W Costa
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; The Jackson Laboratory, Bar Harbor, ME, USA
| | - Andrew J Perry
- Monash Bioinformatics Platform, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Jessica Hatwell-Humble
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; Biomedical Manufacturing, CSIRO Manufacturing, Bag 10, Clayton South, Australia
| | | | - Hieu T Nim
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; Faculty of Information Technology, Monash University, Clayton, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Systems Biology Institute Australia, Clayton, Victoria, Australia
| | - Yuan M M Ji
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Natalie Charitakis
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Denis Bienroth
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia
| | - Francesca Bolk
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Melbourne Centre for Cardiovascular Genomics and Regenerative Medicine, The Royal Children's Hospital, Melbourne 3052, VIC, Australia
| | - Celine Vivien
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia
| | - Anja S Knaupp
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, Victoria, Australia; Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Wellington Road, Clayton, Victoria, Australia; Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - David R Powell
- Monash Bioinformatics Platform, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - David A Elliott
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia
| | - Enzo R Porrello
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Melbourne Centre for Cardiovascular Genomics and Regenerative Medicine, The Royal Children's Hospital, Melbourne 3052, VIC, Australia; Department of Anatomy and Physiology, School of Biomedical Sciences, The University of Melbourne, Melbourne 3010, VIC, Australia
| | - Susan K Nilsson
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; Biomedical Manufacturing, CSIRO Manufacturing, Bag 10, Clayton South, Australia
| | - Gonzalo Del Monte-Nieto
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Nadia A Rosenthal
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; The Jackson Laboratory, Bar Harbor, ME, USA; National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Fernando J Rossello
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, Victoria, Australia; Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Wellington Road, Clayton, Victoria, Australia; Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; University of Melbourne Centre for Cancer Research, University of Melbourne, Melbourne, Victoria, Australia.
| | - Jose M Polo
- Department of Anatomy and Developmental Biology, Monash University, Wellington Road, Clayton, Victoria, Australia; Development and Stem Cells Program, Monash Biomedicine Discovery Institute, Wellington Road, Clayton, Victoria, Australia; Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia.
| | - Mirana Ramialison
- Australian Regenerative Medicine Institute, Monash University, Wellington Road, Clayton, Victoria, Australia; The Jackson Laboratory, Bar Harbor, ME, USA; Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, VIC, Australia; Systems Biology Institute Australia, Clayton, Victoria, Australia.
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Liberos A, Rodrigo M, Hernandez-Romero I, Quesada A, Fernandez-Aviles F, Atienza F, Climent AM, Guillem MS. Phase singularity point tracking for the identification of typical and atypical flutter patients: A clinical-computational study. Comput Biol Med 2018; 104:319-328. [PMID: 30558815 DOI: 10.1016/j.compbiomed.2018.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 11/17/2022]
Abstract
Atrial Flutter (AFL) termination by ablating the path responsible for the arrhythmia maintenance is an extended practice. However, the difficulty associated with the identification of the circuit in the case of atypical AFL motivates the development of diagnostic techniques. We propose body surface phase map analysis as a noninvasive tool to identify AFL circuits. Sixty seven lead body surface recordings were acquired in 9 patients during AFL (i.e. 3 typical, 6 atypical). Computed body surface phase maps from simulations of 5 reentrant behaviors in a realistic atrial structure were also used. Surface representation of the macro-reentrant activity was analyzed by tracking the singularity points (SPs) in surface phase maps obtained from band-pass filtered body surface potential maps. Spatial distribution of SPs showed significant differences between typical and atypical AFL. Whereas for typical AFL patients 70.78 ± 16.17% of the maps presented two SPs simultaneously in the areas defined around the midaxialliary lines, this condition was only satisfied in 5.15 ± 10.99% (p < 0.05) maps corresponding to atypical AFL patients. Simulations confirmed these results. Surface phase maps highlights the reentrant mechanism maintaining the arrhythmia and appear as a promising tool for the noninvasive characterization of the circuit maintaining AFL. The potential of the technique as a diagnosis tool needs to be evaluated in larger populations and, if it is confirmed, may help in planning ablation procedures.
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Affiliation(s)
- A Liberos
- ITACA Institute, Universitat Politècnica de València, Spain; Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain.
| | - M Rodrigo
- ITACA Institute, Universitat Politècnica de València, Spain; Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - I Hernandez-Romero
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain; Department of Signal Theory and Communications, Rey Juan Carlos University, Spain
| | - A Quesada
- Department of Cardiology, Hospital General Universitari de València, Spain
| | - F Fernandez-Aviles
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - F Atienza
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - A M Climent
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain.
| | - M S Guillem
- ITACA Institute, Universitat Politècnica de València, Spain
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