Left Atrial Appendage Analysis from Echocardiographic Images: Relevance in Left Atrial Appendage Occlusion

Abstract

Abstract Atrial fibrillation, a prevalent cardiac arrhythmia, disrupts the normal path of electrical signals within the heart. To address this issue, the left atrial appendage closure is often considered. This involves using a closure instrument named the Watchman to obstruct the left atrial appendage (LAA) ostium. The wide variety of LAA shapes, sizes, and forms in individuals makes selecting the correct Watchman size crucial. This study first isolates the LAA from echocardiographic images and then recommends the appropriate Watchman size. The 3-D echocardiographic images used in this study are from 32 male and female patients who underwent successful LAA closure at Kings College Hospital London over two years. For each patient, there are 208 cardiac echo slices in the imaging mode. This study presents an image processing-based model to separate LAA regions and extract relevant features. These features are then inputted into a classification platform in which a neural network determines the suitable Watchman size. The average and mode Hausdorff distances, calculated between the proposed method and the traditional manual calculation for the 501 analyzed LAA images, are approximately 0.2467 and 0.0587, respectively. Because of limited data, a 10-fold cross-validation was used to assess the classifier, yielding an accuracy of 74.07 %. The proposed model effectively isolated the LAA from the corresponding slices of the 3-D echocardiographic images. However, the classifier’s accuracy is not ideal because of insufficient data, which could be improved by expanding the database. This research’s outcomes could aid physicians in selecting the proper Watchman size.