Abstract
Atrial fibrillation involves structural, hemodynamic, and electrophysiological remodeling that is often quantified separately. We present an integrated framework derived from a single ECG-gated contrast-enhanced cardiac CT acquisition, using the systolic phase for anatomy, EAT, CFD, and EP simulations, and paired systolic-diastolic phases when available for LAA volumetric function. The framework was applied to 2,739 patients (1,641 men / 1,098 women; mean age 66.8 ± 13.5 years). Higher regional epicardial adipose tissue (EAT) volume showed modest but coherent associations with thrombogenic appendage flow and slower regional conduction after adjustment for left-atrial volume and age; inferior-wall EAT also separated inducible from non-inducible AF patients after multiple-testing correction. In contrast, appendage hemodynamic descriptors did not discriminate inducibility, and appendage volumetric function showed limited correspondence with computational-fluid-dynamics-derived flow after accounting for chamber size. These findings support a multiparametric interpretation of atrial remodeling in which imaging-derived fat distribution, local hemodynamics, and electrophysiological vulnerability provide complementary information.
Links to Paper and Supplementary Materials
Main Paper (Open Access Version): https://papers.miccai.org/miccai-2026-sat/paper/STACOM2026_029.pdf
SharedIt Link: Not yet available
SpringerLink (DOI): Not yet available
Supplementary Material: Not Submitted
Link to Open Review
Open Review Page: https://openreview.net/profile?id=~%C3%88ric_Lluch1
BibTex
@InProceedings{LluÈri_Integrated_MICCAISAT2026,
author = { Lluch, Èric AND Raghunath, Adarsh AND Castaneda Gavina, Eduardo AND Passerini, Tiziano AND Mihalef, Viorel AND Jacob, Athira J. AND Ashikaga, Hiroshi AND Frings, Oliver AND Redheuil, Alban},
title = { { Integrated CT-derived left atrial digital twins reveal complementary thrombogenic and arrhythmogenic substrates in atrial fibrillation } },
booktitle = {Medical Image Computing and Computer Assisted Intervention -- MICCAI 2026 Workshops and Challenges},
year = {2026},
publisher = {Springer Nature Switzerland},
volume = {LNCS 17267},
month = {pending},
page = {pending}
}