Abstract

Computational models of atrial fibrillation have successfully been used to predict optimal ablation sites. A critical step to assess the effect of an ablation pattern is to pace the model from different, potentially random, locations to determine whether arrhythmias can be induced in the atria. In this work, we propose to use multi-fidelity Gaussian process classification on Riemannian manifolds to efficiently determine the regions in the atria where arrhythmias are inducible. We build a probabilistic classifier that operates directly on the atrial surface. We take advantage of lower resolution models to explore the atrial surface and combine seamlessly with high-resolution models to identify regions of inducibility. We test our methodology in 9 different cases, with different levels of fibrosis and ablation treatments, totalling 1,800 high resolution and 900 low resolution simulations of atrial fibrillation. When trained with 40 samples, our multi-fidelity classifier that combines low and high resolution models, shows a balanced accuracy that is, on average, 5.7% higher than a nearest neighbor classifier. We hope that this new technique will allow faster and more precise clinical applications of computational models for atrial fibrillation. All data and code accompanying this manuscript will be made publicly available at: https://github.com/fsahli/AtrialMFclass.

Highlights

  • Atrial Fibrillation (AF) is the most common cardiac arrhythmia and a significant contributor to morbidity and mortality (Virani et al, 2021)

  • We develop Gaussian process (GP) classifiers that can operate on manifolds, such as the atrial surface

  • We propose a novel methodology to estimate the AF inducibility regions of a computational model of the human atria

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Summary

INTRODUCTION

Atrial Fibrillation (AF) is the most common cardiac arrhythmia and a significant contributor to morbidity and mortality (Virani et al, 2021). A common approach to investigate AF is to stimulate a high fidelity model from different pacing sites and observe whether this arrhythmia was induced or not (Boyle et al, 2019). With these simulations, it is possible to create an inducibility map that shows the regions of the atria where AF will manifest if stimulated (Potse et al, 2018). The problem of creating an inducibility map can be seen as a classification problem, from a machine learning perspective The labels, in this case, are the occurrence or absence of AF when we pace the model from a specific site, which corresponds to the input.

Atrial Modeling
Pacing Protocol for Atrial Fibrillation
Classification With Gaussian Processes
Gaussian Process Priors on Manifolds
Bayesian Inference
Multi-Fidelity Classification With
Active Learning
Numerical Assessment
Characterization of Inducibility Regions
DISCUSSION
Findings
DATA AVAILABILITY STATEMENT
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