Surface flattening of the human left atrium and proof-of-concept clinical applications

Rashed Karim, YingLiang Ma, Munjung Jang, R James Housden, Steven E Williams, Zhong Chen, Asghar Ataollahi, Kaspar Althoefer, C Aldo Rinaldi, Reza Razavi, Mark D O'Neill, Tobias Schaeftter, Kawal S Rhode

    Research output: Contribution to journalArticlepeer-review

    26 Citations (Scopus)
    45 Downloads (Pure)


    Surface flattening in medical imaging has seen widespread use in neurology and more recently in cardiology to describe the left ventricle using the bull's-eye plot. The method is particularly useful to standardize the display of functional information derived from medical imaging and catheter-based measurements. We hypothesized that a similar approach could be possible for the more complex shape of the left atrium (LA) and that the surface flattening could be useful for the management of patients with atrial fibrillation (AF). We implemented an existing surface mesh parameterization approach to flatten and unfold 3D LA models. Mapping errors going from 2D to 3D and the inverse were investigated both qualitatively and quantitatively using synthetic data of regular shapes and computer tomography scans of an anthropomorphic phantom. Testing of the approach was carried out using data from 14 patients undergoing ablation treatment for AF. 3D LA meshes were obtained from magnetic resonance imaging and electroanatomical mapping systems. These were unfolded using the developed approach and used to demonstrate proof-of-concept applications, such as the display of scar information, electrical information and catheter position. The work carried out shows that the unfolding of complex cardiac structures, such as the LA, is feasible and has several potential clinical uses for the management of patients with AF.

    Original languageEnglish
    Pages (from-to)251-66
    Number of pages16
    JournalComputerized Medical Imaging and Graphics
    Issue number4
    Early online date2 Feb 2014
    Publication statusPublished - Jun 2014

    Bibliographical note

    Open Access funded by Wellcome Trust
    Under a Creative Commons license


    • Algorithms
    • Atrial Fibrillation
    • Computer Simulation
    • Female
    • Heart Atria
    • Humans
    • Image Interpretation, Computer-Assisted
    • Imaging, Three-Dimensional
    • Magnetic Resonance Imaging
    • Male
    • Middle Aged
    • Models, Cardiovascular
    • Pilot Projects
    • Reproducibility of Results
    • Sensitivity and Specificity
    • Surface Properties
    • Surgery, Computer-Assisted
    • Journal Article
    • Research Support, Non-U.S. Gov't


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