Comparison of LGE-MRI and Local Impedance Data Recorded in Human Left Atria

Abstract Efficient personalized ablation strategies for treating atrial arrhythmias remain challenging. Discrepancies in identifying arrhythmogenic areas using characterization methods, such as late gadolinium enhanced magnetic resonance imaging (LGE-MRI) and electroanatomical mapping, require a comparative analysis of local impedance (LI) and LGE-MRI data. This study aims to analyze correlations as basis for improvement of treatment strategies. 16 patients undergoing left atrium (LA) ablation with LGE-MRI acquisition and LI data recording were recruited. LGE-MRI data and LI measurements were normalized to patient- and modality-specific blood pool references. A global mean shape was generated based on all patient geometries, and normalized local impedance (LI N ) and LGE-MRI image intensity ratio (IIR) data points were coregistered for comparison. Data analysis comprised intra-patient and inter-patient assessments, evaluating differences in LIN values among datasets categorized by their IIR. Due to substantial deviations in LI N values, even within the same patient and IIR-category, discerning the presence or absence of a correlation was challenging, and no statistically significant correlation could be identified. Our findings underscore the necessity for standardized protocols in data acquisition, processing, and comparison, to minimize unquantified confounding effects. While immediate substitution of LI for LGE-MRI seems improbable given the significant LI N variations, this preliminary study lays the groundwork for systematic data acquisition. By ensuring data quality, a meaningful comparison between LI and LGE-MRI data can be facilitated, potentially shaping future strategies for atrial arrhythmia treatment.