A technique for visualising three-dimensional left atrial cardiac activation data in two dimensions with minimal distance distortion

Electro-anatomic mapping and medical imaging systems, used during clinical procedures for treatment of atrial arrhythmias, frequently record and display measurements on an anatomical surface of the left atrium. As such, obtaining a complete picture of activation necessitates simultaneous views from multiple angles. In addition, post-processing of three-dimensional surface data is challenging, since algorithms are typically applicable to planar or volumetric data. We applied a surface flattening methodology to medical imaging data and electro-anatomic mapping data to generate a two-dimensional representation that best preserves distances, since the calculation of many clinically relevant metrics, including conduction velocity and rotor trajectory identification require an accurate representation of distance. Distance distortions were small and improved upon exclusion of the pulmonary veins. The technique is demonstrated using maps of local activation time, based on clinical data, and plotting rotor-core trajectories, using simulated data.