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Grant support

This work was supported by: The UK Department of Health (via the NIHR comprehensive Biomedical Research Centre award to Guys & St. Thomas NHS Foundation Trust in partnership with KCL and King's College Hospital NHS Foundation Trust and the Healthcare Technology Co-operative for Cardiovascular Disease); the Wellcome Trust-EPSRC Centre of Excellence in Medical Engineering [WT 088641/Z/09/Z]; the British Heart Foundation [PG/15/8/31130] to MV and OA; the Wellcome Trust and the Royal Society [WT 099973/Z/12/Z] to PL; the H2020 EU Framework Programme for Research and Innovation [655020-DTI4micro-MSCA-IF-EF-ST] to EZ and a grant by La MARATO - TV3 (ID 201527) to FB.

Analysis of institutional authors

Trucco , Maria EmilceAuthorBerruezo, AntonioAuthorMont, LluisAuthor

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February 24, 2025
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Novel Computational Analysis of Left Atrial Anatomy Improves Prediction of Atrial Fibrillation Recurrence after Ablation

Publicated to:Frontiers In Physiology. 8 68- - 2017-02-14 8(), DOI: 10.3389/fphys.2017.00068

Authors: Varela, Marta; Bisbal, Felipe; Zacur, Ernesto; Berruezo, Antonio; Aslanidi, Oleg V; Mont, Lluis; Lamata, Pablo

Affiliations

Hosp Badalona Germans Trias & Pujol, Arrhythmia Unit, Heart Inst iCor, Badalona, Spain - Author
Kings Coll London, Div Imaging Sci & Biomed Engn, Dept Biomed Engn, London, England - Author
Univ Barcelona, Hosp Clin, Unitat Fibrillacio Auricular, Barcelona, Spain - Author
Univ Oxford, Dept Engn Sci, Oxford, England - Author

Abstract

he left atrium (LA) can change in size and shape due to atrial fibrillation (AF)-induced remodeling. These alterations can be linked to poorer outcomes of AF ablation. In this study, we propose a novel comprehensive computational analysis of LA anatomy to identify what features of LA shape can optimally predict post-ablation AF recurrence. To this end, we construct smooth 3D geometrical models from the segmentation of the LA blood pool captured in pre-procedural MR images. We first apply this methodology to characterize the LA anatomy of 144 AF patients and build a statistical shape model that includes the most salient variations in shape across this cohort. We then perform a discriminant analysis to optimally distinguish between recurrent and non-recurrent patients. From this analysis, we propose a new shape metric called vertical asymmetry, which measures the imbalance of size along the anterior to posterior direction between the superior and inferior left atrial hemispheres. Vertical asymmetry was found, in combination with LA sphericity, to be the best predictor of post-ablation recurrence at both 12 and 24 months (area under the ROC curve: 0.71 and 0.68, respectively) outperforming other shape markers and any of their combinations. We also found that model-derived shape metrics, such as the anterior-posterior radius, were better predictors than equivalent metrics taken directly from MRI or echocardiography, suggesting that the proposed approach leads to a reduction of the impact of data artifacts and noise. This novel methodology contributes to an improved characterization of LA organ remodeling and the reported findings have the potential to improve patient selection and risk stratification for catheter ablations in AF.

Keywords

atrial fibrillationbiomarker classificationcomputational anatomyleft atrial remodelingAtrial fibrillationBiomarker classificatioBiomarker classificationCatheter ablationComputational anatomyLeft atrial remodelingModelRecurrence risk assessmentShapeVolume

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Frontiers In Physiology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2017, it was in position 20/83, thus managing to position itself as a Q1 (Primer Cuartil), in the category Physiology.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.94. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 16.68 (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-04, the following number of citations:

  • WoS: 53
  • Scopus: 25
  • Europe PMC: 33

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 88.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 88 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 5.35.
  • The number of mentions on the social network X (formerly Twitter): 4 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United Kingdom.