Ensemble learning of the atrial fiber orientation with physics-informed neural networks

The anisotropic structure of the myocardium is a key determinant of the cardiac function. To date, there is no imaging modality to assess in-vivo the cardiac fiber structure. We recently proposed Fibernet, a method for the automatic identification of the anisotropic conduction -- and thus fibers -- in the atria from local electrical recordings. Fibernet uses cardiac activation as recorded during electroanatomical mappings to infer local conduction properties using physics-informed neural networks. In this work, we extend Fibernet to cope with the uncertainty in the estimated fiber field. Specifically, we use an ensemble of neural networks to produce multiple samples, all fitting the observed data, and compute posterior statistics. We also introduce a methodology to select the best fiber orientation members and define the input of the neural networks directly on the atrial surface. With these improvements, we outperform the previous methodology in terms of fiber orientation error in 8 different atrial anatomies. Currently, our approach can estimate the fiber orientation and conduction velocities in under 7 minutes with quantified uncertainty, which opens the door to its application in clinical practice. We hope the proposed methodology will enable further personalization of cardiac digital twins for precision medicine.