arXiv:2508.07621cs.CVcs.AI2025-08中稿 · MICCAI 2025被引 1

用AI模拟心脏消融效果并优化参数,降低房颤复发风险

SOFA: Deep Learning Framework for Simulating and Optimizing Atrial Fibrillation Ablation

  • 基于患者心肌MRI和消融参数生成术后瘢痕图像
  • 优化后预测复发风险降低22.18%
  • 首个融合模拟、预测与参数优化的一体化框架

房颤(AF)是常见的心律失常,常通过导管消融治疗,但疗效差异大。由于个体组织特征与操作参数间复杂交互,评估和提升消融效果困难。本文提出SOFA(Simulating and Optimizing Atrial Fibrillation Ablation)框架,解决两个问题:能否通过模拟操作参数影响预测房颤复发?如何优化消融策略以降低复发?SOFA首先基于患者术前LGE-MRI和消融参数(如位置、时间、温度、功率、力),生成术后瘢痕图像,并预测复发风险;随后引入优化方案,调整参数以最小化预测风险。该方法采用多模态、多视角生成器处理心房的2.5D表示。定量评估显示,SOFA能准确合成术后图像,优化使模型预测复发风险降低22.18%。据我们所知,SOFA是首个集成消融效果模拟、复发预测与参数优化的框架,为房颤消融个性化提供新工具。

原文摘要 · Abstract (English)

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia often treated with catheter ablation procedures, but procedural outcomes are highly variable. Evaluating and improving ablation efficacy is challenging due to the complex interaction between patient-specific tissue and procedural factors. This paper asks two questions: Can AF recurrence be predicted by simulating the effects of procedural parameters? How should we ablate to reduce AF recurrence? We propose SOFA (Simulating and Optimizing Atrial Fibrillation Ablation), a novel deep-learning framework that addresses these questions. SOFA first simulates the outcome of an ablation strategy by generating a post-ablation image depicting scar formation, conditioned on a patient's pre-ablation LGE-MRI and the specific procedural parameters used (e.g., ablation locations, duration, temperature, power, and force). During this simulation, it predicts AF recurrence risk. Critically, SOFA then introduces an optimization scheme that refines these procedural parameters to minimize the predicted risk. Our method leverages a multi-modal, multi-view generator that processes 2.5D representations of the atrium. Quantitative evaluations show that SOFA accurately synthesizes post-ablation images and that our optimization scheme leads to a 22.18\% reduction in the model-predicted recurrence risk. To the best of our knowledge, SOFA is the first framework to integrate the simulation of procedural effects, recurrence prediction, and parameter optimization, offering a novel tool for personalizing AF ablation.

房颤消融深度学习个性化医疗

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