Predicting thrombotic risk in atrial fibrillation using imaging, modelling and simulation

Every third person in Sweden is expected to suffer from atrial fibrillation (AF) at some point in their lives.

These patients have an increased risk of stroke, caused by thrombi formed in the heart in the setting of flow abnormalities particularly in the left atrial appendage (LAA) which can embolize downstream resulting in ischemic events. Anticoagulant medication can decrease the stroke risk, but at the cost of increased risk of serious bleeding.

Currently, an individual’s stroke risk is roughly estimated by a measure based on age, gender, and history of previous diseases.

A better risk assessment would avoid  preventable episodes of bleeding and ischemic strokes.The location, shape and dynamic motion of the LAA make its assessment very challenging.

Furthermore, many patients suffer intermittent periods of arrhythmia, and might therefore be examined either during normal sinus rhythm or while in the throes of arrythmia.The goal of this multidisciplinary project is to obtain a personalized blood flow-based estimation of thrombus risk in patients with atrial fibrillation during both regular and irregular rhythm.We will therefore obtain an efficient pipeline for blood flow simulations from 4D CT and Photon Count CT (PCCT), model flow in atrial fibrillation from an exam recorded in normal sinus rhythm, and utilize and evaluate these techniques to investigate the relation between prothrombotic flow conditions and thrombotic risk in atrial fibrillation.