CHARIGMA: Characterisation of Wall Properties for Image Guided Managmement of Atrial Fibrilation

STW Perspectief CARISMA (project 11634)


The last decade has shown an increasing number of ablation procedures based on anatomic considerations.
The largest part concerns catheter ablation of Atrial Fibrillation (AF).

Knowledge of the true sites of the ablation lesions following ablation therapy for the treatment of atrial fibrillation is of vital importance to electrophysiologists for the assessment of gaps in the ablation patterns or large areas of edema that could be causing temporary electrical block.

The ability to image and quantify atrial wall properties, such as, thickness and acute RF ablation lesions would be of great benefit in the early determination of gaps in the ablation patterns.

Emerging techniques rely on manual segmentation or thresholding of scar, introducing the potential for high user error. To obtain information about local left atrial (LA) myocardial wall thickness, a pre-segmentation tool including both endocardial and epicardial surface detection is required. Acute and chronic scar have to be quantified for therapy success assessment.

Segmentation of the LA epicardial border and local atrial wall thickness quantification is largely unexplored territory.

We propose to develop novel techniques for the quantification of wall properties of the LA (thickness, edema, scar) and for segmentation of the esophagus. We propose to use coupled double segmentation techniques based on either level sets or graph-theory. The image data used as an input will be from both multi slice CT and high-resolution MR, the latter of which is developed at KCL, one of the partners.

We expect this project to yield these novel techniques, the performance of which will be fully evaluated, leading to improved ablation results, and better assessment tools for therapy success.

Project Team:

  • Hans van Assen ( - Project Leader
  • Ahmed Othman – PhD student


  • M.M.J. Koppert, P.M.J. Rongen, M. Prokop, B.M. ter Haar Romenij, and H.C. van Assen, “Cardiac left atrium CT image segmentation for ablation guidance”, From Nano to Macro : Proceedings of the 7th IEEE International Symposium on Biomedical Imaging, 14-17 april 2010, Rotterdam, The Netherlands, Piscataway, NJ, 2010, pp. 480–483.